Abstract
ObjectiveTo evaluate the efficacy of ultra-early rehabilitation on elbow function after Slongo’s external fixation for supracondylar humeral fractures in older children and adolescents.MethodsWe retrospectively analyzed clinical data from 49 older children (> 8 years) and adolescents with supracondylar humerus fracture who were treated with Slongo’s external fixation in our hospital from January 2016 to August 2020. Twenty-three patients received ultra-early postoperative rehabilitation (rehabilitation group) and 26 patients were not subjected to postoperative rehabilitation (control group). Time to ROM required for functional activity of daily living(ROM-ADL) in both groups was recorded postoperatively. Patients were followed up at 3 and 6 months after surgery to compare the elbow range of motion (ROM) and carrying angle (CA). Postoperative complications were assessed in both groups. Flynn scores and modified Mayo Elbow Performance Scores were also performed.ResultsThe elbow function at 6 months after surgery was significantly better than that at 3 months in the control group (P = 0.32). Time to ROM-ADL in the rehabilitation group was significantly shorter than that of the control group (P = 0.028). The elbow function, Flynn scores, and modified Mayo scores in the rehabilitation group at 3 and 6 months after surgery were significantly better than that of the control group (P(ROM, 3 months and 6 months) = 0.012 vs 0.039; P(Flynn scores, ROM, 3 months and 6 months) = 0.028 vs 0.005; P(Flynn scores, CA, 3 months and 6 months) = 0.032 vs 0.026; P(Modified Mayo scores, 3 months and 6 months) = 0.039 vs 0.024; respectively). There were no iatrogenic injuries, secondary fracture displacements, myositis ossificans, elbow deformities, or other complications in either group. One case of nail tract infection occurred in the rehabilitation group and was cured.ConclusionSlongo’s external fixation is a safe and effective surgical treatment for supracondylar humeral fractures in children over 8 years old and adolescents. Ultra-early rehabilitation treatment for postoperative children can significantly speed up the recovery after surgery.
Highlights
Supracondylar humeral fracture is the most common elbow fracture in children
Supracondylar humeral fractures are commonly divided into three types according to the modified Gartland classification, while surgical treatment is recommended for Gartland II and III fractures in children [4]
Patients We retrospectively analyzed clinical data of 49 older children (> 8 years) and adolescents with supracondylar humeral fractures who were treated with closed reduction and Slongo’s external fixation in our hospital from January 2016 to August 2020
Summary
Supracondylar humeral fracture is the most common elbow fracture in children It usually occurs in children between the ages of 5 and 7 [1, 2]. Supracondylar humeral fractures are commonly divided into three types according to the modified Gartland classification, while surgical treatment is recommended for Gartland II and III fractures in children [4]. As a relatively new surgical method, external fixation has become a treatment choice for supracondylar humeral fracture in older children and adolescents. This technique can enable children and adolescents to perform early elbow joint functional exercises after surgery, reducing the risk of elbow stiffness
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