تاثير وضعيت گچ گيري و جا اندازي بازو ثابت كردن شكستگي هاي سوپراكونديلار بازو در پيدايش تغيير شكل آرنج

Effect of Open Reduction and Immobilization Position in Elbow Deformity in Supracondylar Fractures of Humerus

Background: Supracondylar fractures of humerus are the most common fractures around elbow in children. Type III supracondylar fractures often need surgical treatment. Cubitus varus deformity is one of the complications of such of fracture which does not, spontaneously, correct. Some investigators believe that type III fractures, whether treated closed or with internal fixation, should be immobilized in pronation to avoid varus deformity. The present investigation is aimed at testing this belieff. Materials and Methods: Out of 84 type III supracondylar humerus fractures who had been treated by open reduction and internal fixation over a 2 year period in our center (Ahvaz hospitals), 27 participated in this study. These patients were all immobilized in supination or neutral position after surgery. On an average follow up of 40 weeks the cases were evaluated clinically and radiographically and comparison made with the opposite elbow. Results: In all cases except one who had cubitus valgus the carrying angles were equal to the healthy elbow. No difference between Bowmann, ulnohumeral or metaphysiodiaphyseal angles was observed between the affected elbows with the normal opposite sides. Conclusion: The most important factor, determining development of cubitus varus or valgus is accurate reduction and stable fixation. Position of forearm after such reduction does not affect the results as for as deformity is concerned.