The Use of a Joystick Technique Facilitates Closed Reduction and Percutaneous Fixation of Multidirectionally Unstable Supracondylar Humeral Fractures in Children

Abstract

Level IV-case series.

A comparative study of two closed reduction methods for pediatric supracondylar humeral fractures

“…To improve the success rate of closed reduction, some authors had proposed different joystick technique [1,2,13,14]. Novais EN et al [1] recommend placing a K-wire in the distal fragment from lateral to medial direction as a joystick for facilitating closed reduction. Herzog MA et al [13] inserted a Schanz pin in the proximal fragment from posterior to anterior direction to aid closed reduction.…”

“…As a result, how to get a satisfactory closed reduction poses a challenge to surgeons. To improve the success rate of closed reduction for supracondylar humeral fractures, surgeons have suggested some methods [1,2,13,14]. They usually use a Kirschner pin (or a Schanz pin) in the distal or proximal fragment of supracondylar humeral fractures as a joystick for facilitating closed reduction [1,2,13,14].…”

Results of displaced supracondylar humerus fractures treated with open reduction and internal fixation after a mean 22.4 years of follow-up

“…Recent studies support closed reduction and percutaneous pinning as the treatment of choice for displaced supracondylar humerus fractures. 12,16,17 Although irreducible supracondylar fractures are uncommon, 2% to 12% are irreducible by closed means and require open reduction. 22,30 The many methods advocated for supracondylar fractures of the humerus in children suggest that no single technique is suitable for all types of fractures.…”

The Outcome of Surgical Treatment of Multidirectionally Unstable (Type IV) Pediatric Supracondylar Humerus Fractures

“…5 Type IV fractures represent a surgical challenge. Although specific modification of traditional techniques for closed reduction and pinning of SCHFs have been described for this particular type of injury, 8,9 they are certainly more difficult to reduce than other types of SCHFs. Its outcome has rarely been described, but the very limited available literature suggests that a satisfactory outcome can be achieved.…”

“…Its outcome has rarely been described, but the very limited available literature suggests that a satisfactory outcome can be achieved. 8,9 We have identified a group of children who, at the time of surgical reduction of a SCHF, was diagnosed with a type IV SCHF. Our goal is to describe several aspects related to the diagnosis, treatment, and outcome of this complex injury, including issues related to the recovery of range of motion (ROM) and complications, to add to the current knowledge on this rare and challenging injury.…”