Supracondylar fractures of the humerus in children.
Supracondylar fractures of the humerus need a precise treatment in order to obtain a satisfactory result because of the low bone remodeling associated with these injuries. It is important to use a systematic procedure for closed reduction and percutaneous fixation. A retrospective review of fractures treated using two K-wires from the lateral side was done in 77 patients with a mean age of 6.7 years (range, 1-13 years). Displacement of the fracture was classified as Gartland Type II in 39 patients (50.6%) and Gartland Type III in 38 patients (49.4%). The results according to Flynn criteria were excellent in 70 patients (90.9%), fair in three patients (3.9%) and poor in four patients (5.2%), with overall satisfactory results in 96.1% of the cases. In four patients there was secondary displacement of the fragments in internal rotation and three of these patients were operated on again, increasing fixation with a third K-wire either from the lateral or medial side. There were two nerve lesions (2.6%), and four patients (5.2%) had a pulseless pink hand that recovered when the fracture was reduced. In three patients (3.9%) infection developed. To obtain satisfactory results using this procedure, enough stability should be achieved, avoiding iatrogenic damage of the ulnar nerve.
de las Heras
Jorge
J
Hospital Universitario La Paz, Madrid, Spain. jorgeheras@ya.com
Durán
David
D
de la Cerda
Juan
J
Romanillos
Oscar
O
Martínez-Miranda
Jesús
J
Rodríguez-Merchán
E Carlos
EC
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001864:Bone Wires; D002648:Child; D002675:Child, Preschool; D004551:Elbow Joint / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D007223:Infant; D008297:Male; D010372:Pediatrics / Q000379:methods; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000209:etiology; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000209:etiology; D016896:Treatment Outcome; D000092464:Elbow Injuries
D000900:Anti-Bacterial Agents