Closed reduction and fixation for the treatment of Gartland type II and III supracondylar fracture of humerus in children

Objective:To evaluate the feasibility and results of closed reduction and fixation for the treatment of Gartland type Ⅱand Ⅲ supracondylar fracture of humerus in children. Methods:From January 2004 to December 2011,110 children with supracondylar fracture of humerus were treated. Among them,76 patients were boy and 34 patients were girl,ranging in age from 2 to 13 years old,averaged 7 years old. Ninety-eight patients were extension type and 12 patients were flexion type. There were 32 patients with fracture of Gartland type Ⅱ and 78 patients with fractures of Gartland type Ⅲ. Thirty-seven patients had distal rotational displacement. Under anesthesia,the upper arm and forearm of the affected limb were treated with contraction for several minutes. The patients were treated with closed manipulative reduction and plaster external fixation while the satisfactory reduction was confirmed by C-arm X-ray. After the reduction,1 to 2 Kirschner pins were used through the radial side of the skin and plaster external fixation was carried out. Radiographic examination was conducted within 3 to 4 weeks after surgery,and the plaster and Kirschner pins were then removed,accompanied by rehabilitation training of the patients. Results:All the patients were followed up,and the duration ranged from 3 to 18 months,with a mean of 12 months. All fractures healed within 6 to 8 weeks and the average healing time was 6.9 weeks. No complications such as cubitus varus deformity,neurovascular injury or Volkmann's contracture occurred. According to Flynn evaluation criteria,74 patients got an excellent result,26 good and 10 fair. Conclusion:Through carefully reading X-ray films,Gartland type Ⅱ and Ⅲ supracondylar fracture of the humerus in children can be treated with closed reduction,plaster external fixation combined with percutaneous pinning for unstable fracture,which is a simple,less-invasive and satisfactory treatment method.