Is the modified Gartland classification system important in deciding the need for operative management of supracondylar humerus fractures?

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Abstract

14. Eur Rev Med Pharmacol Sci. 2012 Jul;16(7):936-41. Treatment approaches and outcomes in childhood supracondylar humerus fractures. Uçar BY(1), Demirtaş A, Uçar DE. Author information: (1)Department of Orthopaedics and Traumatology, Dicle University Medical Faculty, Diyarbakir, Turkey. drbyucar@yahoo.com BACKGROUND: Being one of the most frequent elbow fractures during childhood, supracondylar humerus fractures require rapid diagnosis and treatment, as they may be associated with significant neurovascular and functional problems. QUESTIONS AND PURPOSES: To evaluate demographic and clinical features, and treatment outcomes of the patients with supracondylar humerus fractures who underwent open reduction+minimal osteosynthesis or closed reduction+percutaneous wiring. PATIENTS AND METHODS: Forty patients (30 boys + 10 girls) between 2 and 13 years of age who were operated on with the diagnosis of supracondylar humerus fracture, between August 2003 and December 2006, were included. Open reduction+minimal osteosynthesis (n=34) and closed reduction+percutaneous wiring (n=6) were performed. The fractures were classified according to the Gartland classification and outcomes were assessed according to Flynn's criteria. RESULTS: All patients (mean age, 7.35 years; range, 2-13 years) had closed fractures (28 left and 12 right). Seven (17.5%) and 33 (82.5%) patients had Gartland type II and III fractures respectively. Three patients had flexion-type and 37 patients had extension-type fractures. Based on Flynn's criteria, cosmetic results were excellent in 37 (92.5%) patients and good in 3 (7.5%) patients, and functional results were excellent in 36 (90%) patients, good in 3 (7.5%) patients, and poor in 1 (2.5%) patient. A surgical success rate of 97.5% was noted. No significant difference was found between wire configurations (p > 0.05). CONCLUSIONS: Treatment of supracondylar humerus fractures in children should be patient-specific based on factors such as patient's age, soft tissue conditions and deformity status.