Implementation of A Protocol for Treatment of Supracondylar Fractures of Humerus in Children.

Abstract

AIM: Supracondylar fractures of the humerus in children are very fearful lesions due to its diagnosis, treatment, associated lesions and the after-effects. Moreover, there are a broad number of treatments. In 2009 we implanted a protocol for the supracondylar fractures treatment.

MATERIAL AND METHODS: Analysis of patients hospitalized with supracondylar fractures of the humerus between March 2009 and March 2011. In the study we analyzed the type of fracture according to Gartland’s classification, type of immobilization and reduction and the number and placing of the Kirschner wires. Independent observer analyzed the results. Non-displaced fractures were not included.

RESULTS: A total of 45 patients were attended during that period. The mean age was 6,9 years old, 66% males and 66% with the left arm injured. Type of fracture: type II (14), type III (31). Three cases were treated with orthopedic management. In 4 cases, closed surgical treatment was not sufficient an open surgery was required. The others (38) were treated with closed surgery. Functional were 38 excellent/good and 7 regular/bad. Radiological result shows a horizontalization of Baumann’s angle related to the crossed pattern of the k-wires (p=0.043). Statistical study shows a relationship between the protocol’s follow-up and good results (p=0.039).

CONCLUSION: Following the protocol guarantees an 84,4% less reinterventions and better clinical outcomes (p=0.039).The crossed pattern of the Kirschner wires presents a good stabilization of the fracture but decreases the Baumann’s angle (p=0.043), and thus increasing the radiological cubital varus although it has no clinical repercussion (p>0.05).