MANAGEMENT OF SUPRACONDYLAR FRACTURE OF HUMERUS IN CHILDREN BY CLOSE REDUCTION AND IMMOBILIZATION OF THE ELBOW IN EXTENSION AND SUPINATION

Authors

  • Iqtidar Ullah Babar
  • Nowroz Shinwari
  • Mohammad Rahim Bangash
  • M Shoaib Khan

Abstract

Background: A Supracondylar fracture of the humerus is the most common fracture in childrenaround the elbow and is also called first decade injury. If not treated properly it may lead todisability due to elbow stiffness, and sequel of neuro-vascular injuries like Volkmann ischemiccontracture etc. This study was undertaken to determine the outcome of close reduction andimmobilization of the elbow in extension and supination in displaced supracondylar fractures ofthe humerus in children. Method: This Quasi-experimental study was conducted in theDepartment of Orthopaedics, Postgraduate Medical Institute, Lady Reading Hospital Peshawar,from January 2007 to December 2007. The inclusion criteria was Gartland Type III (completelydisplaced) supracondylar fractures of the humerus and the exclusion criteria was open or closedGartland type-III fracture associated with neurovascular injury. Close reduction under generalanaesthesia was done and the elbow was immobilized in extension by the application of 2 plasterslabs according. The follow up is based on the overall rating using the modified Flynn globalcriteria. Results: Out of 70 cases, in 56 cases (80%), reduction was acceptable; while in 14 cases(20%) it was unacceptable. Those with unacceptable reduction, 2nd attempt of close reduction weredone but only eight were successful and the other six children required open reduction and internalreduction. Those with acceptable reduction went in to union with the carrying angle ±5º of thecontra-lateral side and full range-of-motion. Excellent result were achieved in 35 cases (50%),good in 15 cases (21.43%), fair in 4 cases (5.71%) and poor in 6 (8.75%) patients. Conclusion:The extension method of close reduction and immobilisation with two slabs is safe method andgive better cosmetic results in uncomplicated type III injures as compared to the flexion method.Keywords: Supracondylar humeral fractures, Close reduction, extension method

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Published

2009-12-01