Evaluation of functional results in the management of supracondylar fracture of humerus in children by different methods

Abstract

Introduction: Supracondylar fractures of humerus in children are not only the commonest fractures but also one of the most difficult fractures to treat. Materials and Methods: 30 Patients with Supracondylar Fracture of Humerus admitted and got treated at Department of Orthopaedics, Aarupadai Veedu Medical and Hospital, Puducherry during the period from 2013 to 2015 were studied after informed consent was obtained from the patients. Results: In this series of 30 patients the youngest patient was 3 years old and the oldest was 14 years old. Most of the patients were between 5-8 years of old age (43.33%). Males (63.33%) were more affected than Females and left side was more involved (73.33%) than right side. According to Gartland’s Classification Type III fracture were more i.e. 63.33%. Type I fractures were treated by above elbow slab in 900–1200 flexion, out of total 3 cases 2 showed excellent results and one showed good result. Type II fractures, out of 8 patients 3 were treated with closed reduction and casting, 2 showed excellent 1 showed good result. Rest 5 patients were treated with closed reduction and k-wire fixation, all showed excellent result. Type III fractures, out of 19 patients 12 patients were treated by closed reduction and K-wire fixation, 10 showed excellent results, 2 showed good results and rest 7 were treated open reduction and K-wire fixation, 2 of them showed excellent, 2 showed good results, 2 showed fair results and 1 poor result. Conclusion: Type I Supracondylar Fractures are treated with immobilization in POP slab for 3 weeks. Type II Supracondylar Fracture treated by closed reduction and Immobilization when the reduction is stable and there is no gross angulations at the fracture site. In Type II when the reduction is unstable or when the fracture shows greater collapse of weakened medial column is being treated by closed reduction and stabilization with K–wire fixation. In Type II and III fractures when closed reduction is not satisfactory and in open fractures, open reduction and stabilization with K- wires, 1 from medial and 1 from lateral end of lower end of humerus in mandatory. In our present study the above protocol of treatment of Supracondylar Fracture has given good cosmetic and functionally satisfied results.