Fixed Time and Fixed Angle External Fixation in the Treatment of Gartland Type III Supracondylar Humerous Fractures in Children

Wei Cai

doi:10.11648/j.ijcems.20180404.11

Abstract

Objective: To assess the efficacy of open reduction internal fixation (ORIF) combined with fixed-time and fixed-angle external fixation (FTFAEF) in the treatment of Gartland type III supracondylar humerous fracture (SHF) in children. Methods: Clinical data of 172 children with Gartland type III SHF from March 2012 to December 2017 were prospectively analyzed. All 172 patients were initially treated with ORIF, then 86 underwent FTFAEF for 3 weeks post-surgery (intervention group) while the remaining 86 received conventional plaster external fixation (70°-90°) for 3 weeks post-surgery (control group). The plaster casts were removed from both groups after the 3-week fixation period and functional exercise was initiated. Regular clinical and radiologic follow-ups were conducted on all patients. Range of motion (ROM) measurements and modified Hospital for Special Surgery (HSS) elbow function assessments were performed at 1 and 3 months post-surgery. Results: At 1 month post-surgery, both ROM and modified HSS scores were significantly higher in the intervention group (85.8±6.1° and 65.2±3.6°, respectively) than in the control group (62.3±5.2° and 56.6±2.1°, respectively)(both P<0.05). After 3 months, both ROM and modified HSS scores were still significantly higher in the intervention group (132.0±4.7° and 98.5±1.3°, respectively) than in the control group (107.5±24.4° and 85.0±10.3°, respectively) (both P<0.05). Furthermore, the percentage of patients scoring excellent on the HSS scale was significantly higher in the intervention group (100%) than in the control group (74.42%) (P<0.05). Conclusions: ORIF combined with FTFAEF is an efficacious approach that should be widely promoted for the treatment of Gartland type III SHF in children.

Highlights

Supracondylar humerus fractures (SHF) are common elbow fractures in children, accounting for 30% - 40% of elbow fractures
Whether the soft tissue presents elastic deformation or plastic deformation depends on the magnitude and duration of the stress
Excellence rate was significantly higher in the intervention group (100%) than in the control group (74.42%) (P

Summary

Introduction

Supracondylar humerus fractures (SHF) are common elbow fractures in children, accounting for 30% - 40% of elbow fractures In some of these severe fractures, such as Gartland type III supracondylar humerus fractures, the clinical symptoms are large displacement of the fracture end, unstable fracture end, and severe soft tissue injury around a joint, which can cause elbow-joint dysfunction if not handled properly. Such fractures require internal fixation for treatment. Elbow organized hematoma and soft tissue contracture are the major causes of elbow-joint dysfunction following an operation of the supracondylar humerus fracture. In the process of repairing the elbow injury, the stress generated during the extending and bending of the elbow joint can

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