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[Supracondylar fractures of the humerus in children]
Per-Henrik Randsborg1, Einar Andreas Sivertsen
1Ortopedisk avdeling, Akershus universitetssykehus, Lørenskog, Norway.
Insights
Percutaneous pinning is the preferred treatment for displaced supracondylar humerus fractures in children, offering good outcomes and reduced complications. This method is cost-effective and minimizes risks compared to casting alone.
Area of Science:
- Pediatric Orthopedics
- Traumatology
Background:
- Supracondylar humerus fractures are prevalent in pediatric populations.
- Severe complications are infrequent, but treatment requires careful consideration.
Purpose of the Study:
- To provide an overview of treatment modalities and prognosis for pediatric supracondylar humerus fractures.
- To evaluate the efficacy and safety of different treatment approaches.
Main Methods:
- Non-systematic literature review of PubMed.
- Analysis of clinical experience and research.
Main Results:
- Undisplaced fractures are managed conservatively with casting.
- Displaced fractures treated with casting alone risk malunion and neurovascular issues.
- Percutaneous pinning after closed reduction is the current treatment of choice, demonstrating lower complication rates than casting alone, reduced risk of cubitus varus deformity, and cost-effectiveness due to shorter hospital stays. Deep infection is rare.
Conclusions:
- Percutaneous pinning is a safe, effective, and economical treatment for displaced pediatric supracondylar humerus fractures.
- This technique offers superior outcomes compared to cast immobilization alone.
Background:
Supracondylar humerus fractures are common in children. Severe complications are rare. We present an overview of treatment options and prognosis.
Material And Methods:
The article is based on a non-systematic search in PubMed and experience from our own clinical research.
Results:
The injury is usually caused by falling from a height with the arm in extension. The mean age is about 6 years. Undisplaced fractures are treated conservatively with a cast. Displaced fractures should not be treated with a cast alone, as this may cause malunions and permanent neurovascular complications. The rate of complications after traction of displaced fractures is substantially lower than for immobilisation in cast alone. Traction and percutaneous pinning yield similar results, but percutaneous pinning is less expensive--mainly because it shortens the hospital stay. In addition, the risk of cubitus varus deformity seems to be reduced. Today the treatment of choice is closed reduction and percutaneous pinning. Choice of pin configuration is at the surgeon's discretion. Crossed pins are more common than two lateral pins, although medial pins can affect the ulnar nerve. However, the affection is almost always transient. Deep infection after percutaneous pinning is very rare.
Interpretation:
Percutaneous pinning of displaced supracondylar humerus fractures in children is cheap and the results are good.
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