Abstract
Background and objectives: Supracondylar humerus fractures are common in children and can be surgically treated. However, the general surgical procedures involving reduction and fixation might lead to reduction loss, failure to direct the Kirschner (K)-wire toward the desired position, prolonged surgery, or chondral damage. This study aimed to show that temporary fixation of closed reduction with a fabric adhesive bandage in pediatric supracondylar humerus fractures could maintain reduction so that surgical treatment can be easily performed by a single physician. Materials and Methods: Forty-six patients with Gartland type 3 supracondylar humerus fractures who underwent surgical treatment between May 2017 and June 2018 were retrospectively evaluated. Fluoroscopy-guided reduction and fixation were performed from the distal third of the forearm to the proximal third of the humerus using a fabric adhesive bandage. Two crossed pins were applied on the fracture line by first inserting a lateral-entry K-wire and then inserting another K-wire close to the anterior aspect of the medial epicondyle and diverging from the ulnar nerve tunnel. A tourniquet was not applied in any patient and no patients required open reduction. Results: The study included 32 boys (69.6%) and 14 girls (30.4%) (mean age, 7.1; range, 2–16 years). The mean hospital stay and follow-up duration were 4.3 ± 3.9 days and 48.1 ± 14.3 weeks, respectively. Heterotopic ossification was detected in one patient, and ulnar nerve neuropraxia was detected in another patient. Functional (according to Flynn criteria) and cosmetic outcomes were excellent in 95.6%, moderate in 2.2%, and poor in 2.2% of patients. The mean duration of fixation of the closed reduction with a fabric adhesive bandage was 8.1 ± 3.9 min, and the mean duration of pinning was 7.9 ± 1.4 min. Conclusions: Temporary preoperative fixation of supracondylar humerus fractures that require surgical treatment with a fabric adhesive bandage may be significantly convenient in practice.
Highlights
Supracondylar humerus fractures are extra-articular fractures that pass through the olecranon fossa and encompass the distal humeral condyles; they are considered distal humerus fractures and the second most common fracture type in children with distal radius fractures [1,2]
Heterotopic ossification was detected in one patient, and ulnar nerve neuropraxia was detected in another patient
Temporary preoperative fixation of supracondylar humerus fractures that require surgical treatment with a fabric adhesive bandage may be significantly convenient in practice
Summary
Supracondylar humerus fractures are extra-articular fractures that pass through the olecranon fossa and encompass the distal humeral condyles; they are considered distal humerus fractures and the second most common fracture type in children with distal radius fractures [1,2]. Medicina 2019, 55, 450 supracondylar fractures constitute the majority (85%) of fractures that require surgical treatment [3,4]. Supracondylar humerus fractures are of great significance as their conservative or surgical treatment could have an effect on the patient’s future lifestyle; these fractures affect hand, wrist, and forearm movements. Their treatment is very important to prevent future functional and cosmetic morbidities [5,6]. This study aimed to show that temporary fixation of closed reduction with a fabric adhesive bandage in pediatric supracondylar humerus fractures could maintain reduction so that surgical treatment can be performed by a single physician. Two crossed pins were applied on the fracture line by first inserting a lateral-entry K-wire and inserting another
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