How safe is the operative treatment of Gartland type 2 supracondylar humerus fractures in children?
Whereas operative treatment of supracondylar fractures is now standard of care for Gartland type 3 supracondylar humerus fractures in children, the treatment of type 2 fractures remains somewhat controversial. The purpose of this article was to examine the safety and efficacy of closed reduction and pinning of type 2 supracondylar humerus fractures in children.


METHODS
We performed a retrospective review of 189 type 2 supracondylar humerus fractures operatively treated at one tertiary care children's hospital from 2000 to 2006. Data were acquired from a review of radiographs and clinical notes.


RESULTS
We found no intraoperative surgical or anesthetic complications in our series. None of our cases lost reduction after closed reduction and percutaneous pinning. There were 4 pin tract infections (2.1%) in our series: 3 were treated with antibiotics, and 1 needed irrigation and debridement in the operating room. This was the only patient who required reoperation for any reason.


CONCLUSIONS
In this study, the largest reported series of type 2 supracondylar humerus fractures in children, we found an extremely low rate of complications after closed reduction and percutaneous pinning; secondary operations were also uncommon (0.5%). Our series demonstrates a high probability of satisfactory outcome after operative treatment of type 2 supracondylar fractures compared with previous studies of children treated by closed reduction without pinning.


METHODS
Therapeutic study, level 4 (case series [no or historical control group]).
Skaggs
David L
DL
Children's Hospital Los Angeles, 4650 Sunset Boulevard, Los Angeles, CA 90027, USA. dskaggs@chla.usc.edu
Sankar
Wudbhav N
WN
Albrektson
Josh
J
Vaishnav
Suketu
S
Choi
Paul D
PD
Kay
Robert M
RM
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001858:Bone Nails; D002648:Child; D002675:Child, Preschool; D003646:Debridement; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000379:methods*; D005596:Fractures, Closed / Q000601:surgery*; D006776:Hospitals, Pediatric; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D007223:Infant; D007239:Infections / Q000209:etiology; D019637:Orthopedic Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000209:etiology; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D007507:Therapeutic Irrigation
D000900:Anti-Bacterial Agents