Objective The standard surgical treatment for supracondylar humeral fractures in children is closed reduction and percutaneous pinning. Given the need for greater fixation strength and higher risk of joint stiffness for children older than 8 years, external fixation is often performed for treating supracondylar humeral fractures in older children. The aim of this study was to compare the efficacy of lateral entry pins and Slongo’s external fixation for treating supracondylar humeral fractures in older children. Methods Children older than 8 years who underwent surgery for supracondylar humeral fractures at our hospital for surgery from January 2016 to December 2020 are to be retrospectively assessed. One group (n = 36) underwent internal fixation and percutaneous pinning with three lateral Kirschner wires, and the other group (n = 32) underwent Slongo’s external fixator surgery. The demographic data, operation duration, number of fluoroscopies, and fracture healing time were compared between both groups. The elbow joint function was evaluated 6 months after the surgery on the basis of fracture healing time, lifting angle, elbow joint range of motion (ROM), and Flynn score. The incidence of postoperative complications was also recorded. Results There was no significant difference between the two patient groups in terms of the demographic parameters. Compared to external fixation surgery, Kirschner wire surgery required shorter duration and fewer fluoroscopies (P < 0.05). Nevertheless, the fracture healing time was significantly less (P < 0.05), and the elbow ROM and Flynn scores were higher in the external fixator group compared to the Kirschner wire fixation group (P < 0.05). There was one case of secondary fracture displacement in the Kirschner wire group and one of pin tract infection in the external fixator group. No other iatrogenic injuries or complications were observed. Conclusion Maybe Slongo’s external fixator is a suitable alternative treatment option for supracondylar humeral fractures in children older than 8 years since it can achieve better fixation strength and early restoration of elbow joint movement with a lower risk of joint stiffness.

Objective To evaluate the efficacy of ultra-early rehabilitation on elbow function after Slongo’s external fixation for supracondylar humeral fractures in older children and adolescents. Methods We retrospectively analyzed clinical data from 49 older children (> 8 years) and adolescents with supracondylar humerus fracture who were treated with Slongo’s external fixation in our hospital from January 2016 to August 2020. Twenty-three patients received ultra-early postoperative rehabilitation (rehabilitation group) and 26 patients were not subjected to postoperative rehabilitation (control group). Time to ROM required for functional activity of daily living(ROM-ADL) in both groups was recorded postoperatively. Patients were followed up at 3 and 6 months after surgery to compare the elbow range of motion (ROM) and carrying angle (CA). Postoperative complications were assessed in both groups. Flynn scores and modified Mayo Elbow Performance Scores were also performed. Results The elbow function at 6 months after surgery was significantly better than that at 3 months in the control group (P = 0.32). Time to ROM-ADL in the rehabilitation group was significantly shorter than that of the control group (P = 0.028). The elbow function, Flynn scores, and modified Mayo scores in the rehabilitation group at 3 and 6 months after surgery were significantly better than that of the control group (P(ROM, 3 months and 6 months) = 0.012 vs 0.039; P(Flynn scores, ROM, 3 months and 6 months) = 0.028 vs 0.005; P(Flynn scores, CA, 3 months and 6 months) = 0.032 vs 0.026; P(Modified Mayo scores, 3 months and 6 months) = 0.039 vs 0.024; respectively). There were no iatrogenic injuries, secondary fracture displacements, myositis ossificans, elbow deformities, or other complications in either group. One case of nail tract infection occurred in the rehabilitation group and was cured. Conclusion Slongo’s external fixation is a safe and effective surgical treatment for supracondylar humeral fractures in children over 8 years old and adolescents. Ultra-early rehabilitation treatment for postoperative children can significantly speed up the recovery after surgery.

Objective: Supracondylar humeral fracture is the most common fracture in children. Currently there are a large number of studies on supracondylar humeral fractures addressing the epidemiology of supracondylar fractures, injury mechanisms, treatments and complications, however there are few studies on how to control the pain in children after fractures and operation. Therefore, we retrospectively analyzed the effectiveness of an intra-articular injection of 0.25% bupivacaine on pain control after CRPP of supracondylar humeral fractures in children. To our knowledge, this is the largest study on the use of an intra-articular injection for pain control after surgery for supracondylar humeral fractures.Methods: This clinical trial was designed to evaluate the efficacy of intra-articular injection of 0.25% bupivacaine as a postoperative pain control in children with supracondylar humeral fractures who underwent closed reduction and percutaneous pinning (CRPP).Subjects (n = 120) were randomized to treatment with 0.25% bupivacaine (treatment group) (n = 60) or no injection (control group) (n =71). After surgery, all patients were prescribed Ibuprofen for analgesia. The Ibuprofen doses and the times of administration were recorded. The Faces Pain Scale-Revised (FPS-R) scores were blindly recorded during postoperative day 1.Results: The results suggested that the use of intra-articular injection of 0.25% bupivacaine improved pain control and decreased the need for Ibuprofen on postoperative day 1. FPS-R scores were also significantly lower in the treatment group as compared with those of the control group. No intra-articular injection-associated complications were reported. Conclusion: Therefore, the intra-articular injection of bupivacaine significantly improves postoperative pain control following CRPP of supracondylar humeral fractures in children.