Advertisement for orthosearch.org.uk
You currently have no access to view or download this content. Please log in with your institutional or personal account if you should have access to through either of these
The Bone & Joint Journal Logo

Receive monthly Table of Contents alerts from The Bone & Joint Journal

Comprehensive article alerts can be set up and managed through your account settings

View my account settings

DISPLACED SUPRACONDYLAR FRACTURES OF THE ELBOW IN CHILDREN

A Report on the Fixation of Extension and Flexion Fractures by Two Lateral Percutaneous Pins



Download PDF

Abstract

Displaced extension supracondylar fractures of the elbow 1. One hundred and ten children were treated by reduction and stabilisation by two pins inserted laterally at an angle of 30 degrees to one another.

2. The complications before and after treatment included fifteen nerve lesions in thirteen patients. The ulnar nerve was involved on one occasion only. Solitary radial nerve injuries occurred with postero-medial displacement of the distal fragment, while median nerve and brachial artery injuries were associated with postero-lateral displacement. All the lesions recovered spontaneously.

3. There were no ischaemic complications after treatment, despite the ligation of one ruptured brachial artery.

4. The average stay in hospital was four days, compared with twenty days for thirty-two other patients treated in traction because of gross oedema.

5. Of eighty patients seen six months to five years after the fracture, seventy (or 87·5 per cent) had excellent or good results, seven patients with marked varus deformities had fair results, and two patients had poor results with very stiff elbows.

Displaced flexion fractures 1. The clinical features, complications and treatment of seventeen cases are described.

2. There were no complications involving the median or radial nerves or the brachial artery, but three patients had a lesion of the ulnar nerve.

3. Nine children had closed reduction and fixation by two lateral percutaneous pins.

4. Reduction was difficult and the results poor compared with extension fractures. Closed reduction failed in one-third of the children, and the functional and cosmetic results were unsatisfactory in over half the patients reviewed.

For access options please click here