Surgical treatment of the severely displaced supracondylar fracture of the humerus in children

Abstract

Objective To study the curative effects of surgical treatment of the severelv displaced supracondylar fracture of the humerus in children. Methods A retrospective investigation was conducted on 316 children with severely displaced supracondylar fracture of the humerus who had been treated with operation in our hospital from June 2001 to June 2006.There were 215 boys and 101 girls,with an average age of 7 years old(range,1 to 14).All were treated with open reduction and internal fixation by Kirschner wire,plaster external fixation after operation,and functional training 2 to 4 weeks postoperatively. Results All the 316 cases were followed up for over 6 months to 5 years, with an average of 2 yearS and 10 months. The functional recovery of the postoperative elbow joint was evaluated by Flynn's criteria.Of them,253 cases were rated as excellent,34 as good,25 as satisfactory,and 4 as poor.Cubitus varus deformity was found in 27 cases. Conclusions Although closed reduction and external fixation is the frst choice for the pediatric supracondylar fracture of the humerus, open reduction and Kirschner wire fixation is necessary for the severely displaced supracondylar fracture of the humerus,including those suffering from failed manipulative reduction,open fracture,vascular and neural injuries and limited function of the elbow joint. Anatomic reduction of broken ends,Kirschner wire internal fixation and early functional training are significant in the therapeutic efficacy of operation,and in the prevention or reduction of postoperative complications. Key words: Children; Humerus; Fracture; Surgical procedures, operative; Elbow joint