Subclassification of Gartland extension-type II paediatric humerus supracondylar fracture using additional characteristics of breach of anterior cortex, presence of medial comminution and disruption of the hourglass minimizes unnecessary surgery

• DOI: 10.1016/j.jorep.2023.100264
• Publication Date: 2023-11-28T04:24:14Z
• Authors: Jie Er Janice Soo; Kenneth Pak Leung...; Neeraj Mishra; Summaiyya Hanum A...; Kar Yee Catrin Kong; Arjandas Mahadev; Sashikumar Ganapathy; Khai Pin Lee; Shu-Ling Chong
• Keywords: Malunion; Hourglass; Comminution

There remains controversy in the management of Gartland Type II fractures. This study reviews outcome and significance stability parameters deciding fracture for fractures hence suitability conservative treatment. is a retrospective observational cohort involving children presenting to Emergency Department between January October 2017 with diagnosis supracondylar humerus (SCHF). We obtained 142 patients (34 operative 108 non-operative), recording their demographics, circumstances injury, X-ray findings those extension type SCHF. Radiological outcomes were assessed using anterior humeral line Baumann's angle. also characteristic which may contribute instability. Data analysed SPSS Statistics Version 26. mean age 5.7 years old (SD ± 2.5). Significant included: breach cortex, presence medial comminution disruption hourglass configuration (p = 0.001, p<0.001, p 0.004 respectively). was no difference malunion, defined either an abnormal (11/34 or 32.4% vs 45/108 41.7%, 0.422) angle (mean 75.2 degrees 73.9 degrees, 0.244). Subclassification extension-type paediatric additional characteristics allows more accurate assessment stability. Hence avoiding minimising unnecessary surgery.