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Neurovascular abnormalities in Gartland III supracondylar fractures in children
R Bălănescu1, Al Ulici, D Rosca
1UMF Carol Davila, Bucharest, Romania.
Insights
This study compared forearm supination versus pronation for treating pediatric elbow fractures. Both reduction methods for Gartland grade III supracondylar humerus fractures showed similar safety and effectiveness regarding neurovascular complications.
Area of Science:
- Orthopedics
- Pediatric Trauma
- Surgical Techniques
Background:
- Supracondylar humerus fractures are common pediatric elbow injuries.
- Posteriorly displaced fractures can present with complex angulation and rotation.
- Gartland grade III fractures require careful reduction to avoid neurovascular compromise.
Purpose of the Study:
- To evaluate if reduction and pinning maneuvers for pediatric supracondylar humerus fractures cause neurovascular abnormalities.
- To compare the neurovascular consequences of reducing Gartland grade III supracondylar humerus fractures using forearm supination versus pronation.
Main Methods:
- Two groups of 40 pediatric patients with Gartland grade III supracondylar humerus fractures were compared.
- Group 1 underwent closed reduction in pronation.
- Group 2 underwent closed reduction in supination.
Main Results:
- No statistically significant differences in clinical outcomes were observed between the two groups.
- No significant differences in neurovascular complications were found between the supination and pronation reduction methods.
- Both closed reduction methods are considered safe and effective for Gartland grade III supracondylar humerus fractures.
Conclusions:
- Forearm supination and pronation are equally safe and effective for closed reduction of Gartland grade III supracondylar humerus fractures.
- Neither reduction technique demonstrated a higher risk of neurovascular complications.
- Both methods are viable options for treating these common pediatric elbow fractures.
Abstract:
The most common elbow injuries in pediatric trauma practice are supracondylar fractures of the humerus. Posteriorly displaced fractures may be angulated or displaced medially or laterally with associated internal or external rotation. We compared two groups of patients, each with grade III supracondylar fractures after Gartland. The goal of this study was to see if reduction and pinning maneuvers create neurovascular abnormalities and if there are any differences in terms of neurovascular consequences for reducing grade III Gartland supracondylar fractures of the humerus using reduction in supination or pronation of the forearm. We formed two study groups based on the reduction method used. Concretely: patients who needed reduction in pronation were included in the first group and patients who needed reduction in supination were included in the second group. Patients were added to each group until every group reached 40, to have equal and comparable groups. No statistically significant differences on clinical outcome and neurovascular complications appeared between the two methods of closed reduction. We can say that both methods used are correct.
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