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J Pediatr Orthop. 2008 Mar;28(2):139-41. doi: 10.1097/BPO.0b013e3181653ac8.

How safe is the operative treatment of Gartland type 2 supracondylar humerus fractures in children?

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1
Children's Hospital Los Angeles, 4650 Sunset Boulevard, Los Angeles, CA 90027, USA. dskaggs@chla.usc.edu

Abstract

Whereas operative treatment of supracondylar fractures is now standard of care for Gartland type 3 supracondylar humerus fractures in children, the treatment of type 2 fractures remains somewhat controversial. The purpose of this article was to examine the safety and efficacy of closed reduction and pinning of type 2 supracondylar humerus fractures in children.

METHODS:

We performed a retrospective review of 189 type 2 supracondylar humerus fractures operatively treated at one tertiary care children's hospital from 2000 to 2006. Data were acquired from a review of radiographs and clinical notes.

RESULTS:

We found no intraoperative surgical or anesthetic complications in our series. None of our cases lost reduction after closed reduction and percutaneous pinning. There were 4 pin tract infections (2.1%) in our series: 3 were treated with antibiotics, and 1 needed irrigation and debridement in the operating room. This was the only patient who required reoperation for any reason.

CONCLUSIONS:

In this study, the largest reported series of type 2 supracondylar humerus fractures in children, we found an extremely low rate of complications after closed reduction and percutaneous pinning; secondary operations were also uncommon (0.5%). Our series demonstrates a high probability of satisfactory outcome after operative treatment of type 2 supracondylar fractures compared with previous studies of children treated by closed reduction without pinning.

LEVEL OF EVIDENCE:

Therapeutic study, level 4 (case series [no or historical control group]).

PMID:
18388704
DOI:
10.1097/BPO.0b013e3181653ac8
[Indexed for MEDLINE]
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