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Operative management of type III extension supracondylar fractures in children

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Abstract

The purpose of this study was to compare primarily open versus primarily closed surgical treatment of Gartland type III extension supracondylar fractures in children. Also the outcomes of different pinning techniques in open surgery were evaluated retrospectively. Eighty displaced type III extension supracondylar fractures treated consecutively at two different centres were included. The treatment protocol of one institute was primarily closed reduction and percutaneous cross-pinning (n = 43). The treatment protocol of the other institute was primarily open reduction and internal fixation (n = 37) with two lateral parallel pins (n = 11), cross pins (n = 11) and two lateral and one medial pin (n = 15) according to the stability and configuration of the fracture. According to Flynn’s criteria the outcomes of the open and closed reduction groups were not statistically significant (P > 0.05). Although the outcomes of closed reduction showed no superiority over open reduction, it should be the first choice of treatment due to its low morbidity and short hospital stay.

Résumé

Le but de cette étude est de comparer le traitement par réduction orthopédique ou réduction sanglante des fractures supracondyliennes type III de Gartland en extension chez l'enfant. Par ailleurs, l'évolution des différentes techniques d'embrochage à foyers ouverts ont également été évaluées de façon rétrospective. Matériel et méthode: 80 fractures en extension de type III supracondyliennes ont été traitées de façon consécutives dans deux centres différents. Le protocole du traitement dans un des centres était la réduction à foyer fermé avec brochage percutané (n = 43) et dans l'autre établissement, à foyer ouvert avec fixation interne (n = 37), deux broches parallèles (n = 11), deux broches en croix (n = 11), deux broches externes et une interne (n = 15), ceci en fonction de la stabilité et de l'aspect de la fracture. Résultats: selon les critères de Flynn, il n'y a pas de différence de résultats entre les traitements à foyer fermé ou après réduction sanglante (p > 0,05). En conclusion: l'évolution des fractures traitées à foyers fermés n'est pas meilleure que celles traitées à foyers ouverts les conditions du choix doivent être la diminution des complications et l'abaissement de la durée moyenne de séjour.

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Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, İzmir Atatürk Training and Research Hospital, Ruzgar sokak No: 45/3, Balcova, Izmir, Turkey

    Cemal Kazimoglu, Murat Çetin & Muhittin Şener

  2. Department of Orthopaedics and Traumatology, İzmir Tepecik Training and Research Hospital, Izmir, Turkey

    Haluk Aguş & Önder Kalanderer

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  1. Cemal Kazimoglu
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  2. Murat Çetin
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  3. Muhittin Şener
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  4. Haluk Aguş
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  5. Önder Kalanderer
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Correspondence to Cemal Kazimoglu.

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Kazimoglu, C., Çetin, M., Şener, M. et al. Operative management of type III extension supracondylar fractures in children. International Orthopaedics (SICOT) 33, 1089–1094 (2009). https://doi.org/10.1007/s00264-008-0605-0

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  • DOI: https://doi.org/10.1007/s00264-008-0605-0

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