Treatment Outcomes of Paediatric Supracondylar Type II Humerus Fracture: Plaster Cast versus Pinning

Akbari Agdam, Hossein; Gholamrezaei, Mohammadreza; Rouhi, Paria; Farrokhzad, Amirhosein

doi:10.22034/ijos.2022.303202.1012

Treatment Outcomes of Paediatric Supracondylar Type II Humerus Fracture: Plaster Cast versus Pinning

Document Type : Original Article

Authors

Hossein Akbari Agdam ¹

Mohammadreza gholamrezaei ²

Paria Rouhi ³

Amirhosein Farrokhzad ⁴

¹ Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

² Medical Student, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

³ Medical Doctor, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

⁴ Department of Orthopaedic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

https://doi.org/10.22034/ijos.2022.303202.1012

Abstract

Background: There is increasing trend of orthopaedic surgeons for closed pinning of type II supracondylar fractures. In this study, the result of treatment of closed reduction and casting in comparison with pinning is evaluated.
Method: In a retrospective cross-sectional study, 39 children aged 3-11 years with Gartland type II supracondylar fracture who were treated with closed reduction and pinning were compared with closed reduction and casting by using demographic information and measurement of Baumann’s angle, and in hospital stay, by easy non-random sampling method and in 4 weeks follow-up.
Result: By using the independent sample T-Test, there was a significant difference between the time duration of hospital stay and type of treatment and it was significantly lower in the group who had undergone treatment with closed reduction and casting [p value < 0.005, Mean, SD: 37.43 +- 6.42]. There was no significant difference between the Baumann’s Angle in the two groups.
Conclusion: No significant difference in the radiographic outcome of the two types of treatment was observed after four weeks of follow-up.

Keywords

Humeral fractures

Fracture fixation Internal

Closed fracture reduction

Treatment outcome

1. Carson S, Woolridge DP, Colletti J, Kilgore K. Pediatric upper extremity injuries. Pediatr Clin North Am. 2006; 53(1):41-67. doi: 10.1016/j.pcl.2005.10.003

2. Hasler CC. Supracondylar Fractures of the Humerus in Children. European Journal of Trauma. 2001; 27(1):1-15. doi: 10.1007/s00068-001-1088-5

3. Barr LV. Paediatric supracondylar humeral fractures: epidemiology, mechanisms and incidence during school holidays. J Child Orthop. 2014; 8(2):167-70. doi: 10.1007/s11832-014-0577-0

4. Amis AA, Miller JH. The mechanisms of elbow fractures: an investigation using impact tests in vitro. Injury. 1995; 26(3):163-8. doi: 10.1016/0020-1383(95)93494-3

5. Zorrilla S, de Neira J, Prada-Canizares A, Marti-Ciruelos R, Pretell-Mazzini J. Supracondylar humeral fractures in children: current concepts for management and prognosis. Int Orthop. 2015; 39(11):2287-96. doi: 10.1007/s00264-015-2975-4

6. Vaquero-Picado A, González-Moran G, Moraleda L. Management of supracondylar fractures of the humerus in children. EFORT Open Rev. 2018; 3(10):526-540. doi: 10.1302/2058-5241.3.170049

7. Mulpuri K, Wilkins K. The treatment of displaced supracondylar humerus fractures: evidence-based guideline. J Pediatr Orthop. 2012; 32‌(Suppl 2):143-52. doi: 10.1097/BPO.0b013e318255b17b

8. Parikh SN, Wall EJ, Foad S, Wiersema B, Nolte B. Displaced type II extension supracondylar humerus fractures: do they all need pinning? J Pediatr Orthop. 2004; 24(4):380-4. doi: 10.1097/00004694-200407000-00007

9. Omid R, Choi PD, Skaggs DL. Supracondylar humeral fractures in children. J Bone Joint Surg Am. 2008; 90(5):1121-32. doi: 10.2106/JBJS.G.01354

10. Vaquero-Picado A, Gonzalez-Morán G, Moraleda L. Management of supracondylar fractures of the humerus in children. EFORT Open Rev. 2018; 3(10):526-540. doi: 10.1302/2058-5241.3.170049

11. Williamson DM, Coates CJ, Miller RK, Cole WG. Normal characteristics of the Baumann (humerocapitellar) angle: an aid in assessment of supracondylar fractures. J Pediatr Orthop. 1992; 12(5):636-9. PMID: 1517426

12. Abzug JM, Herman MJ. Management of supracondylar humerus fractures in children: current concepts. J Am Acad Orthop Surg. 2012; 20(2):69-77. doi: 10.5435/JAAOS-20-02-069

13. Miranda I, Sanchez-Arteaga P, Marrachelli VG, Miranda FJ, Salom M. Orthopedic versus surgical treatment of Gartland type II supracondylar humerus fracture in children. J Pediatr Orthop B. 2014; 23(1):93-9. doi: 10.1097/01.bpb.0000434241.56816.c8

14. Khan MS, Sultan S, Ali MA, Khan A, Younis M. Comparison of percutaneous pinning with casting in supracondylar humeral fractures in children. J Ayub Med Coll Abbottabad. 2005; 17(2):33-6. PMID: 16092647

15. 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(1):64-9. doi: 10.1097/MOP.0000000000000044

16. Ariyawatkul T, Eamsobhana P, Kaewpornsawan K. The necessity of fixation in Gartland type 2 supracondylar fracture of the distal humerus in children (modified Gartland type 2A and 2B). J Pediatr Orthop B. 2016; 25(2):159-64. doi: 10.1097/BPB.0000000000000251

17. Kropelnicki A, Ali AM, Popat R, Sarraf KM. Paediatric supracondylar humerus fractures. Br J Hosp Med (Lond). 2019; 80(6):312-316. doi: 10.12968/hmed.2019.80.6.312

18. Hussein Al-Algawy AA, Aliakbar AH, Witwit IHN. Open versus closed reduction and K-wire fixation for displaced supracondylar fracture of the humerus in children. Eur J Orthop Surg Traumatol. 2019; 29(2):397-403. doi: 10.1007/s00590-018-2305-9

19. Padman M, Warwick AM, Fernandes JA, Flowers MJ, Davies AG, Bell MJ. Closed reduction and stabilization of supracondylar fractures of the humerus in children: the crucial factor of surgical experience. Journal of pediatric orthopedics Part B. 2010; 19(4):298-303.

20. Vaquero-Picado A, González-Morán G, Moraleda L. Management of supracondylar fractures of the humerus in children. EFORT Open Rev. 2018; 3 (10):526-40.

21. Williamson DM, Coates CJ, Miller RK, Cole WG. Normal characteristics of the Baumann (humerocapitellar) angle: an aid in assessment of supracondylar fractures. Journal of pediatric orthopedics. 1992; 12 (5):636-9.

22. Abzug JM, Herman MJ. Management of supracondylar humerus fractures in children: current concepts. The Journal of the American Academy of Orthopaedic Surgeons. 2012; 20(2):69-77.

23. Miranda I, Sánchez-Arteaga P, Marrachelli VG, Miranda FJ, Salom M. Orthopedic versus surgical treatment of Gartland type II supracondylar humerus fracture in children. Journal of pediatric orthopedics Part B. 2014; 23 (1):93-9.