title: [Treatment of displaced humeral supracondylar fractures in children with external fixation using plaster or splint].
abstract: OBJECTIVE
  To investigate the therapeutic effects of closed reduction and external fixation (plaster or splint) for the treatment of displaced humeral supracondylar fractures in children.
  
  
  METHODS
  From March 2007 to September 2009,33 children (15 female and 18 male) with humeral supracondylar fractures treated in our hospital, ranging from 3 to 12 years old with an average of 6.4 years old. All the fractures were extension-type injuries, the flexion injures were excluded in our study. The humeral supracondylar fractures were classified according to Gartland classification. There were 21 Type H and 12 type III. In the initial treatment, all the patients were treated with closed reduction and external immobilization. The blood supply of the damaged upper extremity was evaluated before and after treatment. Clinical assessment was obtained at final follow-up using Flynn criteria, and radiologic assessment was obtained using Baumann and lateral humerocapitellar angles.
  
  
  RESULTS
  All the children were treated successfully with closed reduction in the initial time; 24 children maintained limb alignment by external immobilization. Nine patients lost position due to the swelling around the elbow which affected unstable external fixation during the follow-up, 5 of which were treated with a repeated closed reduction and internal fixation with Kirschner wires, 4 of which were treated with traction. Thirty-one patients had a satisfactory outcome and 2 patients had an unsatisfactory outcome according to the Flynn criteria at the latest follows-up.
  
  
  CONCLUSIONS
  Closed reduction and external stabilization is an important method for the treatment of displaced humeral supracondylar fractures in children. Making regular follow-up visits after closed reduction and casting is important for patients to maintain acceptable alignment, avoid complications and diagnose any loss of reduction.
authors.affiliation: Department of Orthopaedics, Changping Hospital of Dongguan, Dongguan 523573, Guangdong, China.
authors.forename: Ping-xian
authors.initials: PX
authors.lastname: Tan
authors.forename: Gan-hu
authors.initials: GH
authors.lastname: Ye
authors.forename: Shao-dong
authors.initials: SD
authors.lastname: Ren
authors.forename: Zhi-qi
authors.initials: ZQ
authors.lastname: Hou
authors.forename: Guo-xin
authors.initials: GX
authors.lastname: Zhou
authors.forename: Yong-gang
authors.initials: YG
authors.lastname: Tu
authors.forename: Ying
authors.initials: Y
authors.lastname: Tan
authors.forename: Zhi-sen
authors.initials: ZS
authors.lastname: Zhou
mesh_terms: D002370:Casts, Surgical; D002648:Child; D002675:Child, Preschool; D016267:External Fixators; D005260:Female; D005593:Fracture Fixation, Internal; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D008297:Male; D013165:Splints