EVALUATION OF COMPLICATIONS BETWEEN TYPE II AND III FRACTURES ACCORDING TO GARTLAND CLASSIFICATION IN PEDIATRIC SUPRACONDYLAR HUMERUS FRACTURE

Study goal was to evaluate, to compare treatment outcomes and complications for children with displaced humerus fracture. Distribution of subjects by age, gender, dominant hand and distribution of subjects according to the fracture mechanism and the Gartland classification were evaluated.

The supracondylar humerus fracture is often found in the work of a pediatric traumatologist and is considered to be the most common elbow trauma in pediatric patient. The supracondylar humerus fracture accounts for about 60 percent among all child elbow fractures (1). The most vulnerable children are between 3 and 6 years old (2). Although boys are diagnosed with supracondylar humerus fractures more frequently, the gender distribution is almost the same (48% of girls, 52% of boys) (2,3). Younger children are particularly vulnerable as a result of distal humeral cortex thinning and the interaction between the olecranon and the olecranon fossa in elbow extension during fall (4). The physiological ligamentous laxity also allows the joint to perform hyperextension (5,6). The Wilkins modification of the Gartland classification is currently in use (Table 1). anterior and posterior fat pad sign, sail sign (7,8,9). There are several ways to perform percutaneous osteosynthesis for supracondylar fractures, most commonly Gartland type II and III (9,10).
Research goal was to evaluate and compare treatment methods for children with dislocated humerus fracture. The following tasks were to evaluate distribution of subjects by age, gender, dominant hand and distribution of subjects according to the fracture mechanism and the Gartland classification. Also, to review the outcomes and complications.
The study was performed using retrospective data analysis. The case histories of children who underwent supracondylar humerus fracture and were treated in hospital from 2017 to 2020 were examined. The Hospital Information System (LIS) was used to examine case histories and the Meddream system for X-ray images.
Research population consisted of 125 patients. Research subjects were evaluated by age, sex, side of injured arm, type of fracture, period of wire fixation and complications.
Epidemiological evaluation of patients has been shown to be consistent with other studies. Of the 124 subjects, 59.68% were boys (n = 74) and 40.32% were girls (n = 50). The most common humeral fracture occurs in children aged 5 to 7 years (2). The study found that the average age of boys was 6.1 ± 2.5 years, of girls 5.5 ± SCIENTIFIC COLLECTION «INTERCONF» | № 87 211 2.5 years. L. V. Barr found in a 2018 study that the median age of patients with VGL was 6.1 years and 53% by gender were boys (11). In a 2020 study by Nick I. Pilla and others, 56% were boys and 44% were girls (12). Non-dominant hands are more likely to break. The study found that the left hand broke the most (62.6%, n = 77), which is 1.7 times more common than the right hand. Assessing that righthandedness is the predominant hand dominance, it can be assumed that the nondominant hand is more often injured. According to other authors, about 58% injured the non-dominant hand (12).   In conclusion, boys aged 5-6 are most likely to experience a supracondylar humerus fracture, and the non-dominant hand is injured more often. The most common fracture mechanism is extension-type displaced supracondylar humerus fracture. Two-thirds of the subjects had a type III fracture according to Gartland. Neurovascular complications or contractures were more common in patients with type III fractures.