Management of supracondylar humerus fractures in children: current concepts.
Supracondylar humerus fractures are the most common elbow fractures in the pediatric population. Type I fractures are managed nonsurgically, but most displaced injuries (types II, III, and IV) require surgical intervention. Closed reduction and percutaneous pinning remains the mainstay of surgical management. Numerous studies have reported recent alterations in important aspects of managing these fractures. Currently, many surgeons wait until 12 to 18 hours after injury to perform surgery provided the child's neurovascular and soft-tissue statuses permit. Increasingly, type II fractures are managed surgically; cast management is reserved for fractures with extension displacement only. Two to three lateral pins are adequate for stabilizing most fractures. Evolving management concepts include those regarding pin placement, the problems of a pulseless hand, compartment syndrome, and posterolateral rotatory instability.
Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USA.
Joshua M
JM
Abzug
Martin J
MJ
Herman
D001858:Bone Nails; D002370:Casts, Surgical; D002648:Child; D003161:Compartment Syndromes / Q000209:etiology; D005593:Fracture Fixation, Internal; D006225:Hand / Q000098:blood supply; D006801:Humans; D006810:Humeral Fractures / Q000150:complications / Q000601:surgery*; D010808:Physical Examination; D000092464:Elbow Injuries