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Gartland type I supracondylar humerus fractures in children: is splint immobilization enough?

Authors:
Anna V Cuomo Andrew Howard Sophia Hsueh Kathy Boutis

Pediatr Emerg Care 2012 Nov;28(11):1150-3

Department of Orthopaedics, Shriners Hospital for Children, University of California, Los Angeles, CA, USA.

Objective: The primary objective of this study was to determine if Gartland type I supracondylar humerus (SCH) fractures undergo significant displacement resulting in a change in management when treated with a long-arm splint. Secondary objectives included measured changes at follow-up in displacement and/or angulation.

Methods: This was a retrospective review of children who presented with elbow injuries to a children's hospital. Patients were included if they were diagnosed with a Gartland type I SCH fracture, managed with a long-arm splint, and had at least 1 follow-up visit 2 to 3 weeks from the emergency department visit. The primary outcome was the proportion of cases that required the placement of a circumferential cast and/or an operative intervention. Secondary outcomes included the proportion of cases with significant changes in displacement on any view, Baumann or the lateral humerocapitellar angle, and/or category of position of anterior humeral line relative to capitellum.

Results: Of 804 elbow injuries that presented from 2003 to 2008, 53 patients met the inclusion criteria. The median age of the patients was 4.1 years (interquartile range, 3.4-6.1 years) years. Of the 53, there were no cases that required a change in management. One case had a change in the humerocapitellar angle, and another had a change of 1 category in position of the capitellum relative to the anterior humeral line. There were no other cases of significant changes in displacement or angulation.

Conclusions: These data support that Gartland type I SCH fractures can be treated effectively with long-arm posterior splinting for the duration of therapy.

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http://dx.doi.org/10.1097/PEC.0b013e3182716feaDOI Listing
November 2012

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