CHILDREN'S SUPRACONDYLAR FRACTURES: CONSENSUS AND DIFFERENT PERSPECTIVES (2020)
Ram Prasath P, Dalton J JCR. 2020: 2567-2575
There are two treatments that are most recommended for displaced supracondylar fractures of the humerus, which are closed reductions and percutaneous pinning, but some debate persists regarding pinning techniques, immobilization periods, elbow range of motion exercises, and insight regarding elbow range of motion. Children suffering from supracondylar fractures of the humerus were the focus of this study. Various viewpoints about the treatment of such injuries were investigated in order to establish consensus. This study involved a questionnaire that asked about the type of pin being used, the method of arm joint motion, and perceptions about the degree of elbow range of motion being returned. The number of pediatric orthopedic surgeons was 17, the number of hand surgeons was 48, and the number of general orthopedic surgeons was 11. For children with a displaced supracondylar fracture of the humerus, 95 percent of the musculoskeletal physician recommended closed reduction and percutaneous pinning. A significant difference was shown between the three groups of orthopedic surgeons regarding pin appearance technique (lateral versus crossed pinning, p = 0.017), but not regarding pin number. All groups preferred 2 pins over 3 pins. A removable splint was usually used by orthopedic surgeons during ROM exercises. Children's orthopedic surgeons are less concerned with elbow stiffness after supracondylar fracture, and are more likely to recommend the use of gentle passive motion as elbow motion after supracondylar fracture. Active ROM exercise is the most commonly adopted arm joint motion method by children musculoskeletal physician. In general orthopedic surgery and pediatric musculoskeletal surgery, the long suffering age was the biggest factor in restoring elbow function, while in hand surgery, the extent of injury was the biggest factor in restoring elbow function. There is a need for more investigation and communication between the different subspecialties of orthopedic surgeons regarding the treatment of pediatric supracondylar fractures of the humerus in order to minimize malpractice and avoid the threat of medical malpractice lawsuits.
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