CC BY-NC-ND 4.0 · Revista Chilena de Ortopedia y Traumatología 2023; 64(03): e124-e130
DOI: 10.1055/s-0043-1777719
Artículo Original | Original Article

Radiographic Outcome in Supracondylar Humeral Fractures Gartland Type III

Artikel in mehreren Sprachen: español | English
1   IMSS (Instituto Mexicano del Seguro Social), Oaxaca de Juárez, México
› Institutsangaben

Abstract

Objective This study evaluated Gartland Type 3 supracondylar humeral fracture features before and 3 months after surgical closed reduction.

Material and method Retrospective and observational medical records on 294 cases. We recorded age, gender, lesion mechanism, diagnosis, and classification according to the Gartland and Wilkins system. Radiological characteristics before and 3 months after surgery (Baumann angle, condyle-humeral angle, and rotation) were analyzed with t-Student and chi-square tests.

Results We identified 86 distal humerus fractures, including 75.8% supracondylar humeral fractures. The average age was 5.2 ± 2.8 years old (range, 1 to 14). Per the Garland classification, 45.3% of the fractures were type IIIB and 48.4% were type IIIA. According to Flynn's criteria, 98% had good or excellent outcomes. Postoperative complementary Baumann average angle was 12.8 ± 4.18° (t-Student: -1.94, p: 0.05), and the average condyle humeral angle was 46.9 ± 10.45 (t-Student: 10.68, p <0.001). Postoperative rotation persisted in six cases (chi-square <0.0001, p <0.001).

Discussion Our results are consistent with the international literature. We attributed the lower rate of neurologic lesions in comparison to other papers to lateral stabilization.

Conclusions Closed reduction and percutaneous pinning for treatment of supracondylar humeral fractures Gartland type III resulted in satisfactory outcomes.

Level of Evidence: IV



Publikationsverlauf

Eingereicht: 25. August 2021

Angenommen: 27. November 2023

Artikel online veröffentlicht:
26. Dezember 2023

© 2023. Sociedad Chilena de Ortopedia y Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 
  • Bibliografía

  • 1 Lin-Guo, Xue-Ning Zhang, Jian-Ping Yang. , cols . A systematic review and meta-analysis of two different managements for supracondylar humeral fractures in children. J Orthop Surg Res 2018; 13 (141) 1-9 PubMed
  • 2 Zorrilla S de Neira J, Prada-Cañizares A, Marti-Ciruelos R, Pretell-Mazzini J, Pretell-Mazzini J. Supracondylar humeral fractures in children: current concepts for management and prognosis. Int Orthop 2015; 39 (11) 2287-2296 (SICOT)
  • 3 Scaglione M, Giovannelli D, Fabbri L, Dell'omo D, Goffi A, Guido G. Supracondylar humerus fractures in children treated with closed reduction and percutaneous pinning. Musculoskelet Surg 2012; 96 (02) 111-116
  • 4 Edwardson SA, Murray O, Joseph J, Duncan R. Paediatric supracondylar fractures: an overview of current management and guide to open approaches. Orthop Trauma 2013; 27 (05) 303-311
  • 5 Gartland JJ. Management of supracondylar fractures of the humerus in children. Surg Gynecol Obstet 1959; 109 (02) 145-154
  • 6 Leitch KK, Kay RM, Femino JD, Tolo VT, Storer SK, Skaggs DL. Treatment of multidirectionally unstable supracondylar humeral fractures in children. A modified Gartland type-IV fracture. J Bone Joint Surg Am 2006; 88 (05) 980-985
  • 7 Ladenhauf HN, Schaffert M, Bauer J. The displaced supracondylar humerus fracture: indications for surgery and surgical options: a 2014 update. Curr Opin Pediatr 2014; 26 (01) 64-69
  • 8 Vuillermin C, May C, Kasser J. Closed Reduction and Percutaneous Pinning of Pediatric Supracondylar Humeral Fractures. Bone Joint Surg Am 2007; 89 (04) 706-712
  • 9 Abraham E, Powers T, Witt P, Ray RD. Experimental hyperextension supracondylar fractures in monkeys. Clin Orthop Relat Res 1982; (171) 309-318
  • 10 Ariño VL, Lluch EE, Ramirez AM, Ferrer J, Rodriguez L, Baixauli F. Percutaneous fixation of supracondylar fractures of the humerus in children. J Bone Joint Surg Am 1977; 59 (07) 914-916
  • 11 Larson L, Firoozbakhsh K, Passarelli R, Bosch P. Biomechanical analysis of pinning techniques for pediatric supracondylar humerus fractures. J Pediatr Orthop 2006; 26 (05) 573-578
  • 12 Swenson AL. The treatment of supracondylar fractures of the humerus by Kirschner-wire transfixion. J Bone Joint Surg Am 1948; 30A (04) 993-997
  • 13 Flynn JC, Matthews JG, Benoit RL. Blind pinning of displaced supracondylar fractures of the humerus in children. Sixteen years' experience with long-term follow-up. J Bone Joint Surg Am 1974; 56 (02) 263-272
  • 14 Ducić S, Bumbasirević M, Radlović V. et al. Displaced supracondylar humeral fractures in children: Comparison of three treatment approaches. Srp Arh Celok Lek 2016; 144 (1-2) 46-51
  • 15 Kazimoglu C, Cetin M, Sener M, Aguş H, Kalanderer O. Operative management of type III extension supracondylar fractures in children. Int Orthop 2009; 33 (04) 1089-1094
  • 16 Barr LV. Paediatric supracondylar humeral fractures: epidemiology, mechanisms and incidence during school holidays. J Child Orthop 2014; 8 (02) 167-170
  • 17 Woratanarat P, Angsanuntsukh C, Rattanasiri S, Attia J, Woratanarat T, Thakkinstian A. Meta-analysis of pinning in supracondylar fracture of the humerus in children. J Orthop Trauma 2012; 26 (01) 48-53
  • 18 Farnsworth CL, Silva PD, Mubarak SJ. Etiology of supracondylar humerus fractures. J Pediatr Orthop 1998; 18 (01) 38-42