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KMID : 0378019850280090057
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New Medical Journal
1985 Volume.28 No. 9 p.57 ~ p.65
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A Clinical Study of the Supracondylar Fracture of the Humerus in Children
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Abstract
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Supracondylar fracture is the most common elbow fracture in children, and was called the unsolved fracture to its frequent and serious complication. With advancement of prevention and treatment of serious vascular and, neurologic complications, cubitus varus deformity and limitation of motion which was considered as a necessary evil by McLaughlin remains unsolved. There´s also confusion in the selection of the method of treatment due to its diversity.
18 patients who had been treated for supracondylar fractures of the humerus at Yeung nam University Hospital from May, 1983 to February, 1985 were studied and analyzed retrospectively and the results are summarized as follows;
1. 2 of 5 undisplaced fractures treated by closed reduction with cast immobilization were unsatisfactory cosmetically.
2. 4 to 5 third degree fractures (displaced more than 50%) treated by closed reduction with cast immobilization developed cubitus varus deformities and unsatisfactory in their final results except one.
Another 4 third degree fractures treated by open reduction internal fixation noted good results but one noted extension lag of the elbow.
3. Cubitus varus deformities were noted in 8 of 18 fractures, which included 7 treated by closed reduction with cast immobilization and one treated by closed reduction and percutaneous pinning.
4. 9 of 18 fractures were unsatisfactory in their final results, which included 7 treated by closed reduction with cast immobilization, one by closed reduction and percutaneous pinning, and one by open reduction and internal fixation.
5. We did not experienced any neurovascular complication except one case of transient loss of anterior interosseous nerve.
Open reduction and internal fixation should be considered in the following cases; 1) impossible to obtain the anatomical or acceptable reduction after one or 2 manipulative reduction, 2) unstable maintenance after reduction, 3) threatened by major neurovascular complications.
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