Initial reduction of pediatric type II supracondylar humerus fractures does not guarantee a good outcome

Abstract

Pediatric supracondylar humerus fractures are the most common elbow fracture in the pediatric population.[1] Supracondylar fractures can be mainly divided into extension and flexion types according to the displacement direction of the distal fragment. Extension-type fractures constitute approximately 97% of supracondylar humerus fractures.[2] In supracondylar humerus fractures, the Gartland classification is most commonly used for the evaluation of the fracture and planning of treatment.[3-5] There are nonoperative and operative treatment options for Gartland type II fractures. The condition of vascular and nerve structures should be evaluated with neurovascular examination since complications of these structures can be seen after these fractures.[5] This study aimed to demonstrate effectiveness of conservative treatment in type II supracondylar humerus fracture in a pediatric patient. Pediatric supracondylar humerus fractures are important for orthopedic surgeons because of the high incidence, the accompanying neurovascular injuries, the lack of consensus on the choice of treatment in Gartland type 2 fractures where conservative and surgical treatment options are available, and catastrophic complications. We present the case of a two-year-old male, initially diagnosed as Gartland type 2 and received conservative treatment, which then went on to displacement, necessitating surgical treatment. In conclusion, although a good reduction is achieved with closed reduction and conservative treatment, it should be kept in mind that fracture reduction may be impaired in fractures above the olecranon fossa , and weekly X-ray follow-up should be performed. It should be noted that surgical treatment of these fractures after one or two weeks after the occurrence will be more difficult than treating at injury time.