title: Minimally invasive treatment of 56 consecutive supracondylar fractures of the humerus in children.
abstract: OBJECTIVE
  to present our results from the minimally invasive approach in the treatment of 56 consecutive Gartland types II and III supracondylar fractures of the humerus in school-age patients.
  
  
  METHODS
  Including criteria were isolated supracondylar fractures Gartland types II and III, in the period from January 2011 to November 2011. We admitted 56 children aged four to 12 years (mean 6.9 y.). The most common mechanism of injury was fall with the elbow extended. The treatment procedure consisted of four steps: 1) Classification of the injury according to x-ray findings; 2) Under general anaesthesia, the injured child was placed in a prone position; 3) Closed reduction was obtained by placing the elbow on a special table with the elbow flexed at 90 degrees, using gravity to help reposition; 4) After x-ray verification of the reduction two Sommer pins were inserted to stabilize the fracture. The pins were placed percutaneously through the medial and lateral humeral condyles respectively. After the intervention all elbows were immobilized in a splint cast for 3 weeks.
  
  
  RESULTS
  All patients were followed up for six months. Control radiographs were performed postoperatively, three weeks and two months after the injury. There were no malunions or nonunions. We estimated the elbow function using the Mayo elbow performance index. The functional results were excellent and very good according to the Mayo score.
  
  
  CONCLUSIONS
  We recommend this one-day surgical approach for the treatment of Gartland type II and III supracondylar fractures.
authors.affiliation: University Paediatric Surgery Clinic, Ss. Cyril and Methodius University Medical Faculty, Skopje, R. Macedonia.
authors.forename: Lazar
authors.initials: L
authors.lastname: Todorovic
authors.forename: Mile
authors.initials: M
authors.lastname: Petrovski
authors.forename: Marjan
authors.initials: M
authors.lastname: Kamiloski
authors.forename: Vesna
authors.initials: V
authors.lastname: Cvetanovska
mesh_terms: D000367:Age Factors; D000768:Anesthesia, General; D001696:Biomechanical Phenomena; D001858:Bone Nails; D002370:Casts, Surgical; D002648:Child; D002675:Child, Preschool; D004551:Elbow Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D056888:Patient Positioning; D016684:Prone Position; D011859:Radiography; D020127:Recovery of Function; D013165:Splints; D013997:Time Factors; D016896:Treatment Outcome; D000092464:Elbow Injuries