[Conservative treatment of pediatric elbow fractures]

Between 1978 and 1982, 146 children with elbow fractures were treated at the Department of Traumatology of the Freiburg University Hospital. Forty-two children received conservative treatment and in 104 an operation was performed. The possibilities for conservative treatment of the elbow joint in children are discussed together with our results. Out of 47 supracondylar fractures of the humerus, 25 were treated conservatively (28%, dislocation grade 1; 48%, grade 2). Good or very good results were achieved in more than 76%. Unstable grade 3 fractures often involve rotation of the elbow; in 35% of such cases, conservative treatment leads to a cubitus varus. Operative stabilization is definitely indicated here. Neither serious changes in the carrying angle nor ischaemic contractures were seen. Out of 24 intra-articular fractures of the distal humerus, only 4 were treated conservatively; only fractures without dislocation are regarded as an indication for conservative treatment. Fractures of the neck of the radius were treated conservatively in 6 out of 12 cases. There was angulation of the radius head of more than 30 degrees in 4 cases, necessitating a closed reduction. The follow-up of these children shows very good results in all cases.