Management of supracondylar fractures of humerus with condylar involvement in children.

Abstract

The intent of this study was to heighten awareness and to present the authors' experience of an uncommon supracondylar humerus fracture in children. Twenty-two children were studied over a period of 18 years. The average age was 7 years, and oldest child was 11 years at time of injury. The fracture subtypes with medial condyle, lateral condyle, and intercondylar extensions were classified based on radiographs. The patients were followed for an average of 6.5 years. Eighteen injuries (82%) were graded excellent or good, and there were two each with fair or poor outcomes. The most common complication was loss of carrying angle of more than 10 degrees, which occurred in three children. The best results were seen in cases where three or four cross-fixing wires were used across the fractures. The authors recommend closed reduction techniques and percutaneous multiple cross-pin fixation for the displaced fracture. The fracture is unique and distinctive enough to warrant a designation as supracondylar fracture type IV with subtypes in the younger child.