[Operative treatment of Gartland type III humeral supracondylar fractures in children with minimally invasive incision and percutaneous pinning].
OBJECTIVE
To investigate the operative procedure and the therapeutic effects of minimally invasive incision and percutaneous pinning in operative treatment of Gartland type III humeral supracondylar fracture in children.


METHODS
From September 2002 to July 2009, 189 patients with Gartland type III humeral supracondylar fracture were treated with minimally invasive incision and percutaneous pinning. There were 137 males and 52 females, aged from 1 to 13 years (6.2 years on average). Injury was caused by sports in 173 cases, by traffic accident in 9 cases, by falling from height in 5 cases, and by earthquake in 2 cases. All fractures were closed fractures, complicating others fracture in 11 cases, radial nerve injury in 36 cases, median nerve injury in 5 cases, ulnar nerve injury in 2 cases, and brachial artery injury in 2 cases. The time from injury to hospitalization was 1 hour to 10 days. Neurovascular repair was performed at the same period.


RESULTS
All incisions healed by first intention, no related complications occurred. A total of 143 patients were followed up 5 months to 5 years (12 months on average). X-ray films showed fracture healed within 2-4 months (2.5 months on average). Cubitus varus occurred in 6 cases, but the functions of elbow flexion and extension were good; 2 cases were given distal humeral wedge osteotomy and 4 cases continued keeping the functional training. According to the Flynn et al criteria, the results were excellent in 121 cases, good in 15 cases, and fair in 7 cases; the excellent and good rate was 95.1%. Only a small incision scar was found, the function returned to normal in the cases complicated by nerve and blood vessel injury.


CONCLUSIONS
Minimally invasive incision and percutaneous pinning for operative treatment of Gartland type III humeral supracondylar fracture in children is a safe and effective surgical procedure, which has minimal trauma, short surgery time, quick recovery, simple operation, and can be effective in reducing the complications.
Jiang
Xin
X
Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu Sichuan, P.R. China.
Tang
Xueyang
X
Wang
Daoxi
D
Peng
Mingxing
M
Cheng
Xiaoliang
X
Liu
Lijun
L
D000293:Adolescent; D001860:Bone Plates; D002648:Child; D002675:Child, Preschool; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D007223:Infant; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods