Recent advances in the diagnosis and treatment of supracondylar humeral fractures in children

Abstract

Supracondylar humeral fractures are the most common around elbows in children. Due to special anatomical structure of distal humerus in children, obtaining stable reduction remains difficult and there is a high incidence of postoperative complications. According to the mechanism of injury, supracondylar humeral fractures are divided into extension and flexion types. According to the Gartland classification, supracondylar humeral fractures are divided into Gartland typesⅠ, Ⅱ and Ⅲ. Gartland type I supracondylar fractures of humerus are managed with 3-4 weeks of long-arm cast immobilization with elbow flexed to 90 and forearm held in neutral rotation. Closed reduction followed by stabilization of percutaneous Kirschner wire has been established as a standard treatment for types Ⅱ and Ⅲ supracondylar humeral fractures in children. In recent years, with an improved understanding of supracondylar humeral fractures, needle position appears more and more controversial. Some scholars also have proposed elastic intramedullary pin and external fixator. Postoperative plaster casting is not required and there is a lower incidence of nerve injury. This review summarizes the classification schemes of supracondylar humeral fractures, the therapeutic choices of different types of supracondylar humeral fractures and their merits and demerits. Key words: Humeral fractures; Surgical procedures, operative