The Treatment of Supracondylar Fracture of The Humerus in Children

Kang, Chung Nam; Kim, Jong Oh; Kim, Dong Wook; Koh, Young Do; Kim, Cheol Min; Ko, Sang Hoon; Jeong, Seung Wook

Abstract

Supracondylar fracture of distal humerus is up to 60% of all fractures around the elbow in children. Complications of this fracture include nerve injury, arterial injury, skin slough, Volkmanns ischemic contracuture, and changes in carrying angle. Many different treatment methods to minimize these complications have been devised. Recently, closed reduction and percutaneous pinning with K-wire is most widely used in treating supracondylar fractures in children exept in some rare cases such as unreducible fracture by closed reduction. However, troublesome changes in the carrying angle which do not interfere with function but the appearance of the arm is unsatisfactory, continue in approximately 30% of most series. We reviewed 59 cases which were treated by closed reduction and percutaneous pinning in supracondylar fracuture of the humerus. The purpose of our study is to evaluate the cosmetic and functional results and complications and to analysis the relationship between the stability of reduction and method of pinning. The results are as follows; 1) There were many cosmetic problems, actually. Change over 10 degrees in carrying angle compared to the normal site was as high as 10 cases(17%) of 59 cases. 2) There was no functional problem such as limitatioin of motion. 3) There was no significant complication. 4) The cross pinning fixation was more stable than lateral pinning fixation only. 5) Accurate anatomical reduction is required to prevent unsatisfactory result regardless the treatment method.