Management of completely displaced extention type supracondylar fractures of humerus in children based on a new classification

J Clin Orthop Trauma. 2018 Mar;9(Suppl 1):S106-S111. doi: 10.1016/j.jcot.2017.07.014. Epub 2017 Aug 23.

Abstract

Background: Paediatric supracondylar fractures are the most common childhood fractures under 8 years of age. Displaced paediatric supracondylar fractures are mostly classified on the basis of fracture geometry and none of the classification systems takes the clinical condition of the limb into consideration.

Objective: The purpose of this study was to evaluate the functional outcome of displaced extention type supracondylar fractures of humerus in children managed on the basis of our new classification.

Material and methods: A total of 207 children with displaced extention type supracondylar fractures of humerus were classified as per our classification system into simple and complex types, They were managed and followed over a mean period of 24 weeks, and the results were recorded at the final follow-up.

Results: We had 175 simple and 32 complex fractures. There was a significant difference in mean surgical time between simple (19.64 ± 3.52 min) and complex fractures (43.41 ± 27.07 min). Mean duration of hospital stay was significantly lower in simple fractures (1.02 ± 0.31 days) as compared to complex fractures (2.62 ± 1.84 days). Out of 175 patients in simple group 167 (95.4%) had excellent result,6 (3.4%) had good result 1 (0.6%) had fair result and 1 (0.6%) had poor result whereas out of 32 patients in complex group 10 (31.3%) had excellent result, 5 (15.6%) had good result, 11 (34.4%) had fair result and 6 (18.8) had poor result. Overall results were better in simple group as compared to complex group as per Flynn criteria.

Conclusions: Management of patients with displaced supracondylar fractures of humerus using Barza classification in emergency room gives good result and gives an idea about management and prognosis.

Keywords: Classification; Management; Paediatric fractures; Supracondylar fracture.