Temporary Fixation of Reduction with Fabric Adhesive Bandage in the Surgical Treatment of Pediatric Supracondylar Humerus Fractures

Medicina (Kaunas). 2019 Aug 7;55(8):450. doi: 10.3390/medicina55080450.

Abstract

Background and objectives: Supracondylar humerus fractures are common in children andcan be surgically treated. However, the general surgical procedures involving reduction andfixation might lead to reduction loss, failure to direct the Kirschner (K)-wire toward the desiredposition, prolonged surgery, or chondral damage. This study aimed to show that temporaryfixation of closed reduction with a fabric adhesive bandage in pediatric supracondylar humerusfractures could maintain reduction so that surgical treatment can be easily performed by a singlephysician. Materials and Methods: Forty-six patients with Gartland type 3 supracondylar humerusfractures who underwent surgical treatment between May 2017 and June 2018 were retrospectivelyevaluated. Fluoroscopy-guided reduction and fixation were performed from the distal third of theforearm to the proximal third of the humerus using a fabric adhesive bandage. Two crossed pinswere applied on the fracture line by first inserting a lateral-entry K-wire and then inserting anotherK-wire close to the anterior aspect of the medial epicondyle and diverging from the ulnar nervetunnel. A tourniquet was not applied in any patient and no patients required open reduction.Results: The study included 32 boys (69.6%) and 14 girls (30.4%) (mean age, 7.1; range, 2-16 years).The mean hospital stay and follow-up duration were 4.3 ± 3.9 days and 48.1 ± 14.3 weeks,respectively. Heterotopic ossification was detected in one patient, and ulnar nerve neuropraxia wasdetected in another patient. Functional (according to Flynn criteria) and cosmetic outcomes wereexcellent in 95.6%, moderate in 2.2%, and poor in 2.2% of patients. The mean duration of fixation ofthe closed reduction with a fabric adhesive bandage was 8.1 ± 3.9 min, and the mean duration ofpinning was 7.9 ± 1.4 min. Conclusions: Temporary preoperative fixation of supracondylar humerusfractures that require surgical treatment with a fabric adhesive bandage may be significantlyconvenient in practice.

Keywords: fabric adhesive bandage; fluoroscopy-guided reduction and fixation; supracondylar humerus fractures.

MeSH terms

  • Adolescent
  • Bandages / standards*
  • Bandages / statistics & numerical data
  • Child
  • Child, Preschool
  • Female
  • Fluoroscopy / methods
  • Fracture Fixation / instrumentation*
  • Fracture Fixation / methods
  • Fracture Fixation / standards
  • Fractures, Bone / diagnosis
  • Fractures, Bone / surgery*
  • Humans
  • Humerus / injuries*
  • Humerus / surgery
  • Male
  • Retrospective Studies
  • Surgical Tape / standards
  • Surgical Tape / statistics & numerical data
  • Treatment Outcome
  • Turkey