Acta Chir Orthop Traumatol Cech. 2011; 78(6):519-523 | DOI: 10.55095/achot2011/082

Surgical Treatment of Supracondylar Humerus Fractures in ChildrenOriginal papers

K. REISING*, H. SCHMAL, M. KOHR, K. KUMINACK, N. P. SÜDKAMP, P. C. STROHM
University of Freiburg Medical Center, Department for Orthopedic and Trauma Surgery, Germany

PURPOSE OF THE STUDY:
Surgical techniques for the treatment of supracondylar fractures in children are repeatedly the subject of discussion. The aim of the present study was to compare experience with the technique of crossed Kirschner wires at our own hospital with current literature.

PATIENTS AND METHODS:
In the period from 2000-2006 a total of 86 children aged 1.7 to 12.7 years were treated by means of crossed K-wire osteosynthesis. Follow up was conducted at an average of 32 months. Outcomes were evaluated based on von Laer's criteria.

RESULTS:
Reported complications were migration of the K-wires in 7% of cases and secondary dislocation and re-operation in 4% of cases. Lesion of the radial nerve was diagnosed postoperatively in two cases. Hospital stay was 1.5 days on average. Postoperative immobilization in an upper arm splint and implant removal after 6 weeks on average. 57% of the children received physiotherapy during the course of treatment. Slight varization was found in 11% of children and an unsatisfactory range of motion in 13%. Satisfactory outcomes were recorded for 83% of patients.

CONCLUSION:
K-wire osteosynthesis is associated with a low complication rate and continues to be a safe standard procedure for the stabilization of supracondylar humerus fractures.

Keywords: supracondylar humerus fracture, Kirschner wires, paediatric fractures

Published: December 1, 2011  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
REISING K, SCHMAL H, KOHR M, KUMINACK K, SÜDKAMP NP, STROHM PC. Surgical Treatment of Supracondylar Humerus Fractures in Children. Acta Chir Orthop Traumatol Cech. 2011;78(6):519-523. doi: 10.55095/achot2011/082. PubMed PMID: 22217404.
Download citation

References

  1. DAVIS, R. T., GORCZYCA, J. T., PUGH, K.: Supracondylar humerus fractures in children. Comparison of operative treatment methods. Clin. Orthop. Relat. Res., 376: 49-55, 2000. Go to original source...
  2. GALM P., (Primary Osteosynthesis Failure of the Humerus Supracondylar Fractures in Children, Re-osteosynthesis by Percutaneous Pinning after Conservative Rereduction.). Acta Chir. orthop. Traum. čech., 66: 10-14, 1999.
  3. GORDON, J. E., PATTON, C. M., LUHMANN, S. J., et al.: Fracture stability after pinning of displaced supracondylar distal humerus fractures in children. J. Pediatr. Orthop., 21: 313-318, 2001. Go to original source...
  4. GOSENS, T., BONGERS, K. J.: Neurovascular complications and functional outcome in displaced supracondylar fractures of the humerus in children. Injury, 34: 267-273, 2003. Go to original source... Go to PubMed...
  5. HAVRANEK, P.. (Classification of humeral supracondylar fractures in children.). Acta Chir. orthop. Traum. čech., 65: 277-288, 1998.
  6. HAVRANEK, P., PESL, T.. (Use of the elastic stable intramedullary nailing technique in non-typical pediatric fractures). Acta Chir. orthop.Traum. čech., 69: 73-78, 2002.
  7. KALLIO, P. E., FOSTER, B. K., PATERSON, D. C.: Difficult supracondylar elbow fractures in children: analysis of percutaneous pinning technique. J. Pediatr. Orthop., 1992, 12: 11-15, 1992. Go to original source...
  8. KIM, W. Y.: Early or delayed surgical treatment of supracondylar humeral fractures in children. J. Bone Jt Surg., 84-A: 1079-1080, 2002. Go to original source...
  9. KOCHER, M. S., KASSER, J. R., WATERS, P. M., et al.: Lateral entry compared with medial and lateral entry pin fixation for completely displaced supracondylar humeral fractures in children. A randomized clinical trial. J. Bone Jt Surg., 89-A: 706-712, 2007. Go to original source... Go to PubMed...
  10. KOCHER, M. S., WATERS, P. M., MICHELI, L. J.: Upper extremity injuries in the paediatric athlete. Sports Med., 30: 117-135, 2000. Go to original source... Go to PubMed...
  11. LYONS, J. P., ASHLEY, E., HOFFER, M. M.: Ulnar nerve palsies after percutaneous cross-pinning of supracondylar fractures in children's elbows. J. Pediatr. Orthop., 18: 43-45, 1998. Go to original source...
  12. MANGWANI, J., NADARAJAH, R., PATERSON, J. M.: Supracondylar humeral fractures in children: ten years' experience in a teaching hospital. J. Bone Jt Surg., 88-B: 362-365, 2006. Go to original source... Go to PubMed...
  13. MARZI, I., WESSEL, L. M.: Kindertraumatologie. 2006, 1154-1167.
  14. MEHLMAN, C. T., STRUB, W. M., ROY, D. R., et al.: The effect of surgical timing on the perioperative complications of treatment of supracondylar humeral fractures in children. J. Bone Jt Surg., 83-A: 323-327, 2001. Go to original source... Go to PubMed...
  15. MELLOR, S. J., PATEL, V. R.: Early or delayed surgical treatment of supracondylar humeral fractures in children. J. Bone Jt Surg., 84-A: 1078-1079, 2002. Go to original source...
  16. RAMACHANDRAN, M., BIRCH, R., EASTWOOD, D. M.: Clinical outcome of nerve injuries associated with supracondylar fractures of the humerus in children: the experience of a specialist referral centre. J. Bone Jt Surg., 88-B: 90-94, 2006. Go to original source... Go to PubMed...
  17. SCHAFFER, K., BOHM, R., DIETZ, H. G.: (Elastic stable intramedullary nailing (ESIN) of supracondylar fractures of the humerus in children). Unfallchirurg, 110: 852-858, 2007.
  18. SCHOFER, M., JUNG, W., HUNGER, N., KORTMANN, H.: Kindliche suprakondyläre Oberarmfrakturen. Trauma Berufskrankh., 5: 6-12, 2003. Go to original source...
  19. SKAGGS, D. L., CLUCK, M.W., MOSTOFI, A., et al.: Lateral entry pin fixation in the management of supracondylar fractures in children. J. Bone Jt Surg., 86-A: 702-707, 2004. Go to original source... Go to PubMed...
  20. SLONGO, T., SCHMID, T., WILKINS, K., JOERIS, A.: Lateral external fixation-a new surgical technique for displaced unreducible supracondylar humeral fractures in children. J. Bone Jt Surg., 90-A: 1690-1697, 2008. Go to original source... Go to PubMed...
  21. TALLER, S.: (Use of external fixators in the treatment of supracondylar fractures of the humerus in children). Acta Chir. orthop. Traum. čech., 53: 508-514, 1986.
  22. VON LAER, L., GUNTER, S. M., KNOPF, S., WEINBERG, A.M.: (Supracondylar humerus fracture in childhood-an efficacy study. Results of a multicenter study by the Pediatric Traumatology Section of the German Society of Trauma Surgery II: Costs and effectiveness of the treatment). Unfallchirurg, 105: 217-223, 2002. Go to original source... Go to PubMed...
  23. WEINBERG, A. M., CASTELLANI, C., ARZDORF, M., et al.: Osteosynthesis of supracondylar humerus fractures in children: a biomechanical comparison of four techniques. Clin. Biomech. (Bristol, Avon), 22: 502-509, 2007. Go to original source... Go to PubMed...
  24. WEINBERG, A. M., MARZI, I., GUNTER, S. M., et al.: (Supracondylar humerus fracture in childhood-an efficacy study. Results of a multicenter study by the Pediatric Traumatology Section of the German Society of Trauma Surgery-I: Epidemiology, effectiveness evaluation and classification). Unfallchirurg, 105: 208-216, 2002.
  25. WESSEL, L. M., GUNTER, S. M., JABLONSKI, M., et al.: (Predicting growth patterns after supracondylar fracture of the humerus in childhood). Orthopade, 32: 824-832, 2003. Go to original source... Go to PubMed...
  26. ZIONTS, L. E., MCKELLOP, H. A., HATHAWAY, R.: Torsional strength of pin configurations used to fix supracondylar fractures of the humerus in children. J. Bone Jt Surg., 76-A: 253-256, 1994. Go to original source... Go to PubMed...