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Management of displaced supracondylar fracture of the humerus in children

Background: There have been controversies regarding the ideal method of treatment of displaced supracondylar fractures of the humerus in children. Aims: The aim was to treat displaced supracondylar fractures of the humerus in children by conservative method and if results are not acceptable then by operative method and evolve a management protocol which will provide minimum complications with available facilities. Materials and Methods: This prospective study was conducted in a tertiary care hospital in a time span of 1-year. Ninety patients with Gartland′s Type II and Type III fractures were initially subjected to closed manipulative reduction, of which acceptable reduction could be achieved only in 27 patients. Sixty-three patients who had unacceptable results were subjected to operative treatment. The final results of the treatment were assessed using the criteria of Flynn et al. Results: Among the Gartland′s Type II fracture patients, acceptable reduction was achieved in 9 patients. Among Type III fracture, acceptable reduction was achieved in 18 patients (25%). The conservative treatment yielded excellent results for 9 patient and good for 9 patients. Of the 63 patients subjected to operative treatment, 15 patients had excellent result (23.81%), 24 good (38. 10%), 15 fair (23.81%), and 9 poor (14.29%). Satisfactory result was achieved in 39 patients (61.90%). Conclusion: Closed reduction in case of supracondylar displaced fracture of the humerus in children still remains an option in a developing country. It may be, followed by closed operating techniques when results are not acceptable as this delay does not affect functional outcome.