The treatment of displaced supracondylar fractures of the humerus in children (an evaluation of three different treatment methods)

Abstract

BACKGROUND: Supracondylar fractures of the humerus are the most common fracture pattern of the elbow in childhood. They require close follow-up subsequent to successful treatment, because of having a great risk of many complications. Many treatment methods have been described for the treatment of displaced supracondylar fractures of the humerus, however it has not been reached a consensus for the choice of the treatment. The purpose of this study is to investigate the late results of three different treatment methods; closed reduction+cast immobilization, skeletal traction+cast immobilization and open reduction+internal fixation by K-wires. We also aimed to compare these methods with the results of current literature. METHODS: Fifty-three (41 boys and 12 girls) displaced supracondylar humerus fractures were treated between January 1986 and March 1999. The average age was 8.0 years. We evaluated the results of patients according to Flynn's criterias. RESULTS: According to the results of the study, we obtained 31 excellent, 9 good, 5 fair and 8 poor results. The ratio of poor results of closed reduction+cast immobilization, skeletal traction+cast immobilization and open reduction+internal fixation by K-wires were 28.6%, 14.3% and 12.8%, respectively. CONCLUSION: The datas in our study show that closed reduction+cast immobilization results in the most poorest outcome in the treatment of displaced supracondylar humerus fractures.