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Supracondylar fractures of the humerus in children. A modified technique for closed pinning
Insights
This study shows a modified technique for treating displaced supracondylar fractures of the humerus in children effectively prevents cubitus varus deformity. Strict adherence to protocol ensures excellent outcomes and full range of motion post-treatment.
Area of Science:
- Orthopedic Surgery
- Pediatric Orthopedics
- Traumatology
Background:
- Displaced supracondylar fractures of the humerus (DSFH) in children can lead to complications like cubitus varus.
- Achieving accurate reduction and stable fixation is crucial for preventing long-term deformities.
Purpose of the Study:
- To evaluate a modified closed reduction and percutaneous pinning technique for DSFH.
- To assess the efficacy of this technique in preventing cubitus varus deformity.
- To determine the functional and radiographic outcomes of the modified treatment protocol.
Main Methods:
- Prospective study of 20 children with DSFH.
- Treatment involved closed reduction and percutaneous pinning.
- Intraoperative assessment using Baumann's angle to ensure reduction within 4 degrees of the contralateral side.
Main Results:
- All 20 patients achieved reduction within 4 degrees intraoperatively.
- No patient developed cubitus varus deformity during the follow-up period.
- Average follow-up of 17.2 months showed excellent or good clinical and radiographic results.
Conclusions:
- The modified technique with strict adherence to Baumann's angle guidelines effectively prevents cubitus varus deformity in pediatric DSFH.
- Closed reduction and percutaneous pinning, when precisely performed, leads to favorable outcomes.
- This protocol offers a reliable method for managing displaced supracondylar humerus fractures in children.
Abstract:
Complications in the treatment of displaced supracondylar fractures of the humerus (DSFH), particularly cubitus varus, are a persistent problem. A prospective study was conducted on 20 children with DSFH, using a modified technique to reduce and pin the fracture. All fractures were treated with closed reduction and percutaneous pinning. After the fracture was internally fixed, intraoperative anteroposterior roentgenograms of each distal humerus were compared, using Baumann's angle. The reduction was accepted if Baumann's angle on the fractured extremity was within 4 degrees of that on the normal side. If the angles were not within 4 degrees, the closed reduction and percutaneous pinning was repeated. In this prospective series, all patients had a reduction to within 4 degrees of the normal side before they left the operating room. Three weeks after percutaneous pinning, the pins were removed and range of motion was begun. All patients returned for clinical and roentgenographic examination. With an average follow-up period of 17.2 months, all patients had excellent or good results. No patient developed cubitus varus deformity. Strict adherence to the guidelines of the protocol prevented cubitus varus deformity in this series of children with DSFH.