Supracondylar Fracture of the Humerus in Children: Clinical Study for Cases with Failed Initial Management

Yune, Seung Ho; Lee, Kwang Zin; Lee, June Kyu; Yim, Woo Soon; Hwang, Deuk Soo

Abstract

Supracondylar fracture of the humerus in children is the most common fracture of the elbow in contrast with infant or adult, and there are also many problem in treatment and accompanying complication. These injuries are difficult to manage in case of a delayed initial treatment or repeated close manipulation. We analysed 32 cases which failed and delayed initial management, at department of orthopedic surgery, Chung Nam University Hospital from Jan. 1977 to Dec. 1981. The results obtained were as follows: 1. The cases admitted after unsatisfactory treatment at other hospital among all cases are most common (59.4%). 2. The average duration after trauma are 5.3 days. The average duration until successful reduction after initial trauma are 7.3 days, 3. In types of fracture, there are all displaced supracondylar fracture (Type II, III, IV). 4. In treatments, initial sucessful close reduction are 5 cases (15.6%). The others require other managements, ie, final successful tractions are 5 cases, final sucessful percutaneous pinnings are 5 cases and final open reductions are 16 cases. 5. Cubitus varus deformity was more common in manual reduction and traction groups than in open reduction and percutaneous pinning groups, but limitation of elbow motion was more common in open reduction and percutaneous pinning groups. 6. In complications, there were 5 nerve palsies (4 radial nerves, 1 median nerve), 3 pin tract infections, 1 myositis ossificans, 9 severe cubitus varus and 5 severe limitation of motion.