Çocuk displase suprakondiler humerus kırıklarında tedavi sonuçlarımız

Abstract

Supracondylar fractures of humerus are frequently seen in children and may cause serious complications, that's why they must be carefully evaluated and treated. Most important objectives about treatment are to achieve a cosmetically normal elbow with no limitation of the range of motion (ROM). There are various methods about treatment of Gartland type m (Totally displaced) fractures and there's not decided single method for the treatment of it. In our study we have retrospectively evaluated 142 displaced supracondylar fractures of humerus between January 1990 and June 2006, that we have treated in Ondokuz Mayıs University Department of Orthopaedics and Traumatology Clinic, treatment results of the 54 cases have been evaluated. 106 of the (%74,64) 142 patients were male and 36 of them (%25,35) were females, 86 patients (%60,5) had fractures on their left arm and 56 patients (%39,5) had fractures of their right arm. 134 of the patients had extension type Gartland type JJI fractures , 8 of them had flexion type Gartland type IJJ fracture. Most of the fractures were at summer especially in August and most common reason was to fall on a hard surface. Fractures occured more in boys between 5 to 9 years and in girls between 2 to 7 years and number of fractures decreased in girls after 7 years old. 54 patients who were treated and who have had their last visits had a mean age of 7,06 years and the mean follow up time was 62 months. For the 43 of these 54 patients open reduction and internal fixation with crossed Kirschner wires was performed and closed reduction and percutanous pinning was performed for 1 1 patients. Of the patients who were treated with open reduction success rate was %95,4 in the cosmetic point of view and was %97,7 in the functional point of view. Patients who were treated with closed reduction and percutanous pinning had %100 success rates of cosmetics and function. No significant difference has been noted about range of motion loss and change of the carrying angle. Patients who were operated electively 1 to 3 days after fracture had better results than patients who were operated immediately after fracture and they also had better results than the patients who were operated after 3rd day of fracture. In conclusion in supracondylar fractures of humerus closed reduction and percutanous pinning can be done if there's not much edema, if there's no open fracture, no neurovascular injury and if it's reduced easily. If there's much edema if the fracture isn't reduced easily, if it's an open fracture and if there's concomittant neurovascular injury, then open reduction and internal fixation should be performed. We have also decided that operating a displaced supracondylar fracture of humerus without neurovascular injury electively in the shortest time is a better way than operating them immediately in emergency situations. Keywords: Children fractures, Humerus, Supracondylar fractures. DC