To observe the therapeutic effects of conservative and surgical treatment of Gartland typeⅡsupracondylar fracture of the humerus in children.

Clinical and radiographic information of 142 pediatric typeⅡsupracondylar humerus fracture that were treated in Beijing Children Hospital from February 2018 to February 2019 were reviewed. Inclusion criteria: the first treatment after fracture was in this hospital and the follow-up was completed. Gartland typeⅡsupracondylar fracture of the humerus was diagnosed from X-ray. Exclusion criteria: open fractures and pathological fractures, fractures with vascular nerve injury, missing or incomplete follow-up data, complicated with important organ damage, combined with other ipsilateral limb fractures. Three distinct groups of patients were identified: the patients who were treated nonoperatively (with closed reduction and casting); the patients who were initially treated nonoperatively but subsequently required surgery due to loss of reduction; and the patients who were treated initially with surgery. Treatment outcomes, as assessed by the final clinical and radiographic alignment, range of motion of the elbow, and complications, were compared between the groups to define clinical and radiographic features that related to success or failure of nonoperative management. Analysis of variance was used for comparison between groups. The Fisher exact probability method was used for counting data.

All 142 children in this group were followed up for six to 12 months, arerage time was (8.3±1.9) months.The rate of reduction loss was 19.8% in patients treated conservatively according to the initial treatment. The incidence of needle infection was 7.1% inpatients treated with surgery according to the final treatment. There was no statistically significant difference in fracture healing time among the three groups (P=0.178), but the difference of function recovery time was statistically significant (P=0.008). There was no statistically significant difference in the loss of motion and carrying angle according to the Flynn criteria (P>0.05). At the last follow-up, all the fractures were healed without iatrogenic vascular and nerve injury, Volkmann’s contracture and cubit varus deformity.

Gartland typeⅡsupracondylar humerus fractures can be successfully treated nonoperatively or by surgery. The choice of conservative treatment requires close follow-up and timely surgical treatment if reduction is lost. If close follow-up is not possible, percutaneous k-wire is recommended.Surgical treatment can achieve satisfactory clinical results.