Nonoperative treatment of displaced supracondylar fractures in children: Rigault type 2 fractures.
BACKGROUND
Current opinion in the medical literature concerning displaced supracondylar fractures of the distal humerus recommends pinning because with flexion braces there is a risk of both secondary displacement and Volkmann syndrome.


METHODS
We analyzed 84 children with displaced supracondylar fractures. According to Rigault's classification, 30 children had grade 2 fractures, 21 had grade 3, 28 had grade 4 and 5 had multiple fragments, which were thus outside this classification. Fractures that could be reduced to a stable position under general anesthesia were treated with a posterior long arm splint with an average elbow flexion of 113 degrees (90-140). This technique was applied in 28 of the grade 2 fractures and in 4 of the grade 3 fractures, but in none of the grade 4 fractures.


RESULTS
Of the 4 cases of Rigault grade 3 fractures treated nonoperatively, 3 had to be re-reduced and 1 needed an operation later on for varus correction. Of the 28 Rigault grade 2 fractures, 27 showed excellent results, and 1 had a good result. We advise nonoperative treatment in type 2 supracondylar fractures if stable reduction is achieved.
Service d'Orthopédie et de Traumatologie Pédiatrique, Hôpital des Enfants à Genève, 6, rue Willy Donzé, CH-1211 Geneva, Switzerland. geraldo.decoulon@hcuge.ch
Geraldo
G
de Coulon
Dimitri
D
Ceroni
Vincenzo
V
de Rosa
José Manuel
JM
Pazos
André
A
Kaelin
D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation; D006801:Humans; D006810:Humeral Fractures / Q000145:classification / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome