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Conservative management of displaced paediatric supracondylar fractures: a systematic review

Daniel Yeomans1, Simon M Graham2,3, Nyengo C Mkandawire4,5,6

  • 11 Core Surgical Trainee, North Bristol Trust, Bristol, UK.

Tropical Doctor
|August 30, 2018
PubMed

Insights

Traction management for pediatric distal humerus fractures shows outcomes comparable to surgical pinning in low-resource settings. Closed reduction and casting results were inconsistent, highlighting traction as a viable conservative option.

Area of Science:

  • Orthopedic surgery
  • Pediatric orthopedics
  • Evidence-based medicine

Background:

  • Displaced supracondylar humerus fractures are common in children.
  • Management varies significantly between high-income and low-income countries.
  • Limited resources in low-income countries necessitate conservative treatment options.

Purpose of the Study:

  • To systematically review published evidence on the outcomes of non-operative management for pediatric displaced supracondylar humerus fractures.
  • To compare the effectiveness of traction, closed reduction and casting versus surgical fixation.

Main Methods:

  • Systematic literature review of 46 studies.
  • Inclusion of studies evaluating non-operative management of displaced supracondylar humerus fractures in children.
  • Comparative analysis of treatment outcomes.

Main Results:

  • Traction demonstrated equivalent outcomes to percutaneous pinning.
  • Closed reduction and casting yielded inconsistent results.
  • Limited data exists specifically from low- and middle-income countries (LMICs).

Conclusions:

  • Traction is a viable and effective conservative treatment for pediatric displaced supracondylar humerus fractures, particularly in LMICs.
  • Further research with data from LMICs is needed to fully support these findings.

Keywords:
Castingconservativepaediatricsupracondylartraction

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