title: Management of displaced extension-type supracondylar fractures of the humerus in children.
abstract: The cases of 230 patients who had a displaced extension-type supracondylar fracture of the humerus were reviewed retrospectively. The results of treatment by four different methods were assessed clinically and compared. The mean length of follow-up was 4.6 years (range, one to nine years). The highest percentages of excellent results were achieved by percutaneous Kirschner-wire fixation (78 per cent), skeletal traction (67 per cent), and open reduction with internal fixation (67 per cent). Closed reduction and application of a cast was associated with a significantly lower percentage of early and late complications, including Volkmann ischemic contracture and cubitus varus. It is recommended that treatment with a cast be reserved for undisplaced fractures only. Percutaneous Kirschner-wire fixation is advocated as the method of choice for the majority of displaced fractures.
authors.affiliation: Division of Orthopaedic Surgery, Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: A M
authors.initials: AM
authors.lastname: Pirone
authors.forename: H K
authors.initials: HK
authors.lastname: Graham
authors.forename: J I
authors.initials: JI
authors.lastname: Krajbich
mesh_terms: D000293:Adolescent; D001864:Bone Wires; D002370:Casts, Surgical; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000379:methods*; D005593:Fracture Fixation, Internal; D006801:Humans; D006810:Humeral Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D007223:Infant; D008297:Male; D011859:Radiography; D012189:Retrospective Studies; D014143:Traction