Pediatric humeral supracondylar fracture (phscf)‎ type iii : one month delay? later corrective osteotomy or orif rightaway

Abstract EN

The commonest treatment of displaced PHSCF is closed reduction and percutaneous pinning within 24hours-7th day, after that ORIF usually required.

The purpose of this study was to review the author's experience in treating 17 children delayed for 3–6.5 weeks by ORIF that otherwise left for later corrective osteotomy.

Patient age, sex, mechanism of injury, time and cause of delay, classification of fracture, associated neurovascular injury, preoperative procedures, and complications were noted.

All fractures were treated by OR from posterior approach and fixed with 2 crossed K-wires from medial and lateral condyles.

Wires were removed at 4-5 weeks.

Range of motion and carrying angle were measured at follow up.

A less common fracture type affecting older children was presented, consisting of supra and inter condylar fracture requiring usually ORIF and may affect elbow motion, and suggested to be the 5th type in Gartland's classification.

Conclusion : it is worth to attempt ORIF for late presenting displaced PHSCF even 3-6 weeks after injury. Otherwise the resulting cubitus varus will impose functional, psychological, and cosmetic impairments demanding later corrective osteotomy with much more complications and lower rate of success.