The Journal of Bone and Joint Surgery, Vol 68, Issue 3 333-344, Copyright © 1986 by Journal of Bone and Joint Surgery, Inc
Supracondylar fractures of the humerus in children. Analysis at maturity of fifty-three patients treated conservatively
E Ippolito, R Caterini and E Scola
From a pool of 131 supracondylar fractures of the humerus in 131 patients
who were treated conservatively, all of which healed in an average time of
4.5 weeks without complications related to the treatment itself, the cases
of fifty-three patients were reviewed at maturity. The average age at
follow-up was twenty-six years. Nine patients had unimportant limitation of
elbow motion, and slight atrophy of the musculature of the arm or forearm,
or of both, was present in six patients. Arm-length discrepancy was never
observed. The carrying angle remained at about the same value that had been
present at the time of fracture-healing in eighteen patients, decreased in
twenty-two patients, and increased in thirteen. Malrotation of the distal
fragment of the fracture only rarely caused medial tilting of the fragment
with consequent cubitus varus. Varus deformity was present in four patients
and valgus deformity, in three. None of the patients with valgus deformity
had ulnar-nerve palsy. According to our results, varus and valgus
deformities of the elbow after supracondylar fractures of the humerus seem
to be caused either by growth imbalance of the growth plate of the distal
end of the humerus (four patients) or by malreduction of the fracture
(three patients). Twelve patients in the entire pool had neurological
complications at the time of the fracture. Ten of those patients fully
recovered from the deficit, whereas two--one with a radial-nerve deficit
and the other with ulnar-nerve involvement--still had neurological
impairment at follow-up.
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