Management of supracondylar fractures of the humerus in children: Conservative versus operative

Background and Objectives: Supracondylar fractures of the humerus are the most common fracture pattern of the elbow in children. Severely displaced supracondylar fractures of the distal humerus in children are a challenging problems. Many treatment methods have been described for the treatment of displaced supracondylar fractures of the humerus, however, it has not been reached a consensus for the choice of the treatment. The purpose of this study is to assess and compare the results of two different treatment methods, closed reduction and slab application and open reduction and internal fixation(ORIF) by K-wires for completely displaced supracondylar fractures (type-III fractures). Methods: 40 children (type-I 8, type-II – 12, type-III – 20) of supracondylar humerus fractures were treated. Out of 20 type-III fractures, 10 were treated by closed reduction and external immobilization and 10 by open reduction and internal fixation by K-wire. We evaluated the results of two different methods for type-III fractures according to Flynn’s criteria. Results: According to the study, the ratio of poor results of closed reduction and slab immobilization and open reduction and internal fixation by k-wires for type-III supracondylar fractures were 50% and 10% respectively. Conclusion: The present study shows that open reduction and K-wire fixation has better results compared to closed reduction and slab application for type-III supracondylar fractures of humerus in children. It is recommended that closed reduction and external immobilization be reserved for type-I and type-II fractures.