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Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 3, 362-365.
doi: 10.1302/0301-620X.88B3.16425  
Copyright © 2006 by British Editorial Society of Bone and Joint Surgery
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Supracondylar humeral fractures in children

TEN YEARS’ EXPERIENCE IN A TEACHING HOSPITAL

J. Mangwani, MS(Orth), MRCS, Specialist Registrar1; R. Nadarajah, MRCS, Specialist Registrar2; and J. M. H. Paterson, FRCS, Consultant Paediatric Orthopaedic Surgeon3

1 Colchester General Hospital, Turner Road, Colchester CO4 5JL, UK.
2 Queen Elizabeth Hospital NHS Trust, Stadium Road, Woolwich, London SE18 4QH, UK.
3 Department of Trauma and Orthopaedics, The Royal London Hospital, Whitechapel, London E1 1BB, UK.

Correspondence should be sent to Mr J. Mangwani at 24 Pastoral Way, Warley, Brentwood, Essex CM14 5WF, UK; e-mail: jmangwani{at}hotmail.com

Although supracondylar fracture is a very common elbow injury in childhood, there is no consensus on the timing of surgery, approach for open reduction and positioning of fixation wires. We report our ten-year experience between 1993 and 2003 in 291 children.

Most fractures (285; 98%) were extension injuries, mainly Gartland types II (73; 25%) and III (163; 56%). Six (2%) were open fractures and a neurovascular deficit was seen in 12 (4%) patients. Of the 236 children (81%) who required an operation, 181 (77%) were taken to theatre on the day of admission. Most (177; 75%) of the operations were performed by specialist registrars. Fixation was by crossed Kirschner wires in 158 of 186 (85%) patients and open reduction was necessary in 52 (22%).

A post-operative neurological deficit was seen in nine patients (4%) and three (1%) required exploration of the ulnar nerve. Only 22 (4%) patients had a long-term deformity, nine (3%) from malreduction and three (1%) because of growth arrest, but corrective surgery for functional limitation was required in only three (1%) patients.




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Supracondylar humeral fractures in children
Amit K Kotecha, et al.
J Bone Joint Surg Br Online, 11 Aug 2006 [Full text]

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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General