Abstract
BackgroundSupracondylar fracture with total displacement is classified as Gartland type 3. The operative management for this type of fracture can be closed reduction with percutaneous pinning (CRPP) or open reduction with internal fixation (ORIF). This study aims to determine whether CRPP or ORIF led to smaller changes in Baumann’s angle, the carrying angle, loss of motion, and complication when treating pediatric supracondylar fractures.MethodologyIn a retrospective cohort design, pediatric patients presenting with supracondylar fractures at a tertiary care hospital in Bahrain between March and October of 2021 were enrolled. The collected data included age, gender, nationality, mechanism of injury, neurovascular status, type of surgery performed, follow-up period, range of motion, complications, Baumann’s angle, carrying angle, and loss of motion. The changes in Baumann’s angle, carrying angle, and reduction sufficiency were compared to the literature using Flynn’s criteria for supracondylar fractures.ResultsThis study included the records of 60 patients with supracondylar fractures. In total, 28 patients underwent CRPP (group A), whereas 32 underwent ORIF (group B). A statistically significant difference (p = 0.037) between group A and group B was noted when combining the loss of carrying angle scores and the loss of motion scores to form the final Flynn score. In group A, 26 (92.8%) cases had satisfactory results; 75% of these cases were excellent or good. According to Flynn’s criteria, all patients in group B were satisfactory; 93.75% of these cases were excellent or good. The loss of motion was significantly different between the two groups (p = 0.038). The mean loss of carrying angle was significantly different between the two groups, with 5.51 ± 3.03 degrees for group A and 4.23 ± 1.85 degrees for group B (p = 0.023). The study had only two cases with unsatisfactory ratings belonging to group A.ConclusionsIn pediatric patients presenting with type 3 supracondylar fractures, when compared to CRPP, ORIF was associated with less loss of motion, less loss of carrying angle, higher overall satisfactory results according to Flynn’s criteria, and fewer complications.
Highlights
Supracondylar fractures occur at the distal end of the humerus bone in the arm and are the second most common fracture in children, accounting for 3-18% of all fractures [1,2]
Supracondylar fracture with total displacement is classified as Gartland type 3
This study aims to determine whether closed reduction with percutaneous pinning (CRPP) or open reduction with internal fixation (ORIF) led to smaller changes in Baumann’s angle, the carrying angle, loss of motion, and complication when treating pediatric supracondylar fractures
Summary
Supracondylar fractures occur at the distal end of the humerus bone in the arm and are the second most common fracture in children, accounting for 3-18% of all fractures [1,2]. How to cite this article Abousaleh M A, Zeidan A A, Mukhtar I, et al (February 28, 2022) Comparative Effectiveness of Closed Reduction With Percutaneous Pinning and Open Reduction With Internal Fixation in the Operative Management of Pediatric Type III Supracondylar Fractures. Because elbow injuries are prevalent in the pediatric population due to increased falls, supracondylar fractures are most common in children aged five to seven years [3]. 31.2% and 53.6% of supracondylar fractures occur in children aged four to seven and three to six years, respectively [1,3,4]. The operative management for this type of fracture can be closed reduction with percutaneous pinning (CRPP) or open reduction with internal fixation (ORIF). This study aims to determine whether CRPP or ORIF led to smaller changes in Baumann’s angle, the carrying angle, loss of motion, and complication when treating pediatric supracondylar fractures
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