Supracondylar fractures of the humerus in children. Comparison of results in two treatment periods.
Displaced supracondylar fractures of the humerus in children may be managed with or without Kirschner-wire fixation. The results of treatment of displaced supracondylar fractures of the humerus in children were analyzed, comparing the period before and after an audit of our results in 1997. From 1998 onward a more active policy regarding the use of percutaneous Kirschner-wire fixation was adopted. We treated 33 children between 1991 and 1997 (Period 1) and 49 children between 1998 and 2004 (Period 2). In Period 1, closed reduction and plaster immobilisation was performed in 29 patients. Four received initial Kirschner-wire fixation with plaster immobilisation. Secondary dislocation necessitating re-reduction occurred in 14 patients. In Period 2 initial Kirschner-wire fixation was performed in 41 patients, of whom 23 had open reduction. The other eight had conservative treatment consisting of closed reduction and plaster immobilization, two of them needing re-reduction. This evaluation indicates that a more active policy with regard to (open) reduction with Kirschner-wire fixation in displaced supracondylar humeral fractures in children, results in less need for secondary intervention with comparable functional and cosmetic outcome.
Colaris
J W
JW
Dpt of Orthopedic Surgery, Haga Hospital, The Hague The Netherlands. joostcolaris@hotmail.com
Horn
T M
TM
van den Ende
E D
ED
Allema
J H
JH
Merkus
J W S
JW
D001864:Bone Wires; D002648:Child; D002675:Child, Preschool; D005260:Female; D005593:Fracture Fixation, Internal; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D007103:Immobilization; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome