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Gartland types IIB and III supracondylar fractures of the humerus in children: is Blount's method effective and safe?

Pham, Thuy-Trang and Accadbled, Franck and Abid, Abdelaziz and Ibnoulkhatib, Aissa and Bayle-Iniguez, Xavier and Wargny, Matthieu and Sales de Gauzy, Jérôme Gartland types IIB and III supracondylar fractures of the humerus in children: is Blount's method effective and safe? (2017) Journal of Shoulder and Elbow Surgery, 26 (12). 2226-2231. ISSN 1058-2746

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Official URL: https://doi.org/10.1016/j.jse.2017.05.018

Abstract

BACKGROUND: Blount's method is controversial for the treatment of Gartland types IIB and III supracondylar fracture of the humerus (SCFH) in children. The purpose of this study was to evaluate the clinical and radiologic outcomes and the failure and complication rates. METHODS: All types IIB and III SCFH treated with Blount's method from 2003-2013 were included in this retrospective single-center study. Clinical assessment was performed according to Flynn criteria. Baumann angle, anteversion angle, anterior humeral line, and humeroulnar angle were measured for radiographic assessment. RESULTS: Among 447 children with types IIB and III SCHF, 339 were treated according to Blount's method. There were 173 boys (51%), and the mean age was 6.3 years (1-14 years); 71% were type III. Mean time to surgery was 5.7 hours. According to Flynn criteria, results were satisfactory in 91% of cases. No compartment syndrome was encountered. There were 16 (4.7%) secondary displacements requiring surgical revision. Five (1.9%) children developed a cubitus varus deformity. At latest follow-up, the mean Baumann angle was 74.7° (95% confidence interval, 74.1-75.3), the mean anteversion angle was 39.9° (95% confidence interval, 39.5-40.3), the anterior humeral line was normal in 87.6% of cases, and the mean humeroulnar angle was 8.7°. CONCLUSION: Blount's method is appropriate to manage types IIB and III SCFH, provided anatomic and stable reduction is obtained.

Item Type:Article
HAL Id:hal-02135777
Audience (journal):International peer-reviewed journal
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Institution:Other partners > Centre Hospitalier Universitaire de Toulouse - CHU Toulouse (FRANCE)
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Deposited By: Pascal SWIDER
Deposited On:19 Mar 2019 07:43

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