Treatment of supracondylar fracture of the humerus in children by skeletal traction in a brace

Abstract

In 1980, we developed a specially designed brace for treating supracondylar fractures of the humerus in children, along with an easy and safe technique of reduction by skeletal traction. This method, which takes into consideration only the medial tilting and anterior angulation of the distal fragment, achieves complete reduction, ignoring any lateral, posterior and minor rotational displacements of the fragment. Skeletal traction is applied through a screw inserted into the olecranon and the angulation at the fracture site is reduced regardless of the anatomical position without manipulation. We treated 193 children with displaced supracondylar fractures of the humerus using this method between 1980 and 2001. Only four children (2%) developed cubitus varus. The majority obtained an excellent range of movement at the elbow; one had a 25 degree limitation of flexion. This technique is an effective and easy method of treating supracondylar fractures of the humerus in children.

Outcome of displaced supracondylar fractures in children after manipulation and backslab

“…Traction through an olecranon pin either vertically or in a pre-fabricated brace yielded 84-98% satisfactory results. 3,14,15 Young et al 6 showed 94% satisfactory results using various techniques including plaster casting, overhead skeletal traction and casting and manipulation and K-wires; however, this included undisplaced fractures.…”

“…In displaced fractures (Gartland II and III) cast immobilisation in either flexion or extension, [3][4][5][6][7][8][9] various forms of traction, including horizontal traction, vertical traction, Dunlop traction, 3,6,[10][11][12][13] skeletal traction through an olecranon pin and traction in pre-fabricated braces have been used. 3,6,14,15 The commonly accepted method involves closed reduction and Kirschnerwire (K-wire) fixation, with variation in number of pins and configuration, either medial and lateral wires or only lateral wires, which can be either parallel or crossed. 3,6,[16][17][18][19][20][21] Open reduction is generally reserved for irreducible fractures, vascular compromise and open injuries, but can also be used when attempted reduction is delayed.…”

Dislocated Extension – Type Supracondylar Humerus Fractures in Children: Single Centre Experience

“…Gartland type I fractures are treated with cast immobilization without reduction, followed by excellent results [14,15].…”

Dislocated Extension – Type Supracondylar Humerus Fractures in Children: Single Centre Experience

“…Nowadays different authors have different approach in solving these fractures by using many sorts of apparatuses for reposition, bone traction, and report comparative results with conventional way of treatment. Gartland type I fractures are treated with cast immobilization without reduction, followed by excellent results [14,15].…”