Acta Chir Orthop Traumatol Cech. 2023; 90(3):198-205 | DOI: 10.55095/achot2023/023

A Meta-Analysis on Comparison of Open vs Closed Reduction of Gartland Type 3 Supracondylar Humerus Fractures in ChildrenOriginal papers

S. BARIK1,*, V. GARG2, S. K. SINHA2, S. CHAUDHARY2, P. KANDWAL2, V. SINGH2
1 Department of Orthopedics, All India Institute of Medical Sciences, Deoghar, Jharkhand, India
2 Department of Orthopaedics All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India

PURPOSE OF THE STUDY:
Although there are numerous studies on outcomes and comparison of open and closed reduction but there is no clarity on relationship between outcomes and complications with type of surgical intervention done for Type 3 Gartland supracondylar humerus fracture. The aim of this study is to compare the outcomes and complications of closed vs open reduction in Type 3 Gartland supracondylar humerus fractures.

MATERIAL AND METHODS:
Electronic literature searches of Embase, MEDLINE and the Cochrane Library was conducted in February 2022 using the terms "supracondylar", "humerus", "fracture", "Gartland type 3" and synonymous. The data extracted included the study details, demographic data, procedure performed, final functional and cosmetic outcome according to Flynn criteria and complications of included studies.

RESULTS:
Pooled data analysis revealed no significant difference in mean satisfactory outcome rate according to Flynn cosmetic criteria in open group (97%, 95% CI 95.5%-98.5%), as compared to closed group (97.5%, 95% CI 96.3%-98.7%), although a statistically significant difference in mean satisfactory rate according to Flynn functional criteria in open group (93.4%, 95% CI 90.8%-96.1%) as compared to closed group (98.5%, 95% CI 97.5%-99.4%) was noted. On separate comparison of the two-arm studies, closed reduction favoured better functional outcomes (RR 0.92, 95% CI 0.86-0.99).

CONCLUSIONS:
Closed reduction and percutaneous fixation have better functional outcome than open reduction with K-wire fixation. But there was no significant difference in cosmetic outcomes, overall complication rate and nerve injury with either open or closed reduction. The threshold of converting a closed reduction to an open reduction in supracondylar humerus fractures of children should be high.

Keywords: supracondylar humerus, open reduction, percutaneous pinning, Flynn criteria

Published: June 22, 2023  Show citation

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BARIK S, GARG V, SINHA SK, CHAUDHARY S, KANDWAL P, SINGH V. A Meta-Analysis on Comparison of Open vs Closed Reduction of Gartland Type 3 Supracondylar Humerus Fractures in Children. Acta Chir Orthop Traumatol Cech. 2023;90(3):198-205. doi: 10.55095/achot2023/023. PubMed PMID: 37395427.
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