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Closed Reduction and Percutaneous Pinning versus Open Reduction and Internal Fixation in Pediatric Supracondylar
Febyan Febyan1, Made Agus Maharjana1, Nyoman Gede Grenata Nanda Ustriyana1
1Departamento de Ortopedia e Traumatologia, Prof. Ngoerah General Hospital, Faculty of Medicine, Udayana University, Denpasar, Bali Surabaya, Indonésia.
Insights
Closed reduction and percutaneous pinning (CRPP) and open reduction and internal fixation (ORIF) are equally effective for pediatric supracondylar humerus fractures. Both methods offer viable treatment options, especially for Gartland type III fractures.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Evidence-based medicine
Background:
- Pediatric supracondylar humeral fractures are common injuries.
- Treatment decisions involve balancing efficacy, patient comfort, and outcomes.
- Current evidence comparing closed reduction and percutaneous pinning (CRPP) with open reduction and internal fixation (ORIF) requires synthesis.
Purpose of the Study:
- To systematically review cohort and case-control studies comparing CRPP and ORIF for pediatric supracondylar humeral fractures.
- To evaluate functional outcomes using Flynn's criteria and the Baumann angle.
- To inform clinical decision-making for these fractures.
Main Methods:
- Systematic review of cohort and case-control studies.
- Evaluation of CRPP and ORIF treatment modalities.
- Assessment using Flynn's functional criteria and Baumann angle as outcome measures.
Main Results:
- CRPP and ORIF demonstrate clinical equivalence regarding functional outcomes.
- No significant differences were consistently reported between CRPP and ORIF.
- Limited Baumann angle data precluded definitive comparisons; hospital stay and cosmetic outcomes are important considerations.
Conclusions:
- Both CRPP and ORIF are viable treatment options for pediatric supracondylar humerus fractures.
- These findings are particularly relevant for Gartland type III fractures.
- Further research with larger sample sizes and standardized outcome assessments is recommended.
Abstract:
Objective To compare the treatment approaches of closed reduction and percutaneous pinning (CRPP) and open reduction and internal fixation (ORIF) in pediatric supracondylar humeral fractures through a systematic review of cohort and case-control studies. Methods The CRPP and ORIF treatment modalities were evaluated using Flynn's functional criteria and Baumann angle as outcome measures. Results The results support the clinical equivalence of CRPP ORIF regarding functional outcomes. Despite the limited number of studies and the low level of evidence of the included articles, the present study consistently reported no significant differences, which is in line with the overall results. Limited Baumann Angle data prevented conclusive comparisons in this regard. Factors such as length of hospital stay and cosmetic outcomes influence treatment decisions in pediatric supracondylar humerus fractures. A holistic approach is essential, considering clinical efficacy and patient comfort. Future research should expand the evidence base and standardize outcome assessments. Conclusion Both CRPP and ORIF are viable treatments for pediatric supracondylar humerus fractures, particularly those classified as Gartland type III.
