Medium-term clinical results in the treatment of supracondylar humeral fractures in children: does the surgical approach impact outcomes? in Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology / J Orthop Traumatol. 2024 Sep 11;25(1):43. doi: 10.1186/s10195-024-00781-3.

2024
AOU Alessandria

Tipo pubblicazione

Observational Study

Autori/Collaboratori (5)Vedi tutti...

Samaila EM
Department of Orthopaedics and Trauma Surgery, University of Verona, Verona, Italy. elenamanuela.samaila@univr.it.
Auregli L
Department of Orthopaedics and Trauma Surgery, University of Verona, Verona, Italy.
Pezzè L
Department of Orthopaedics and Trauma Surgery, University of Verona, Verona, Italy.

et alii...

Abstract

BACKGROUND: Recent literature has found a consensus in favor of conservative treatment for type II supracondylar humeral fractures (SCHF). This retrospective observational study compares the short- to medium-term functional outcomes of conservative versus surgical treatment in 31 patients with SCHF (Gartland II and III) to assess the potential superiority of one approach over the other. MATERIALS AND METHODS: Thirty-one pediatric patients treated for SCHF-19 classified as Gartland II and 12 as Gartland III-were assessed in our department. Eight patients underwent closed reduction and cast immobilization, 22 were treated with closed reduction and percutaneous pinning, and one underwent open reduction and internal fixation with plates. Clinical and functional data were collected during follow-up, including elbow and forearm range of motion (ROM), grip strength, carrying angle, Flynn's criteria, and Disabilities of the Arm, Shoulder, and Hand (DASH) score. RESULTS: The average follow-up was 3.3 years (±?1.4 years). All patients demonstrated good functional recovery. According to Flynn's criteria, 85% and 81% of the patients achieved a satisfactory outcome in elbow flexion and carrying angle, respectively. No cases of nerve injuries were reported. Four patients developed cubitus varus in the Gartland II group, which was treated with closed reduction and casting with the initial alignment maintained (without a loss of reduction during the first week). However, compared to this group that was conservatively treated, functional and clinical outcomes were significantly better in the group with SCHF Gartland II treated with reduction and pinning (p?