Does Localisation of Fracture Line, According to Epicondyles, Affect Ligamentotaxis Negatively in Displaced Pediatric Supracondylar Humerus Fractures?

OBJECTIVE: To investigate the effect of localisation of the fracture line according to the trans-epicondylar line on open reduction rates and postoperative reduction quality.

STUDY DESIGN: Observational study.

PLACE AND DURATION OF STUDY: Department of Orthopedic and Traumatology, Prof. Dr. Cemil Taşcıoğlu City Hospital, İstanbul, Turkey, from January 2011 to December 2018.

METHODOLOGY: Pediatric cases (37 females-54 males) which underwent surgery with Gartland type three supracondylar humerus fracture having extension deformity, were included and examined retrospectively. Localisation of fracture line according to trans-epicondylar line, presence of postoperative rotation, sagittal and coronal deformity, reduction type and surgery duration were noted.

RESULTS: According to trans-epicondylar level, fracture line passed through upper level of the line in 68 cases, while it passed through lower level in 23 cases. Rotation rate of patients, whose fraction line localisation was lower according to trans-epicondylar level (60.87%), was higher than upper localization patients (8.82%, p<0.001). It has been observed that the relation between localisation of fracture line according to trans-epicondylar level and sagittal deformity, coronal deformity, reduction type and surgery durations were similar (p>0.05).

CONCLUSION: Determination of localisation of fracture line according to trans-epicondylar level in preoperative roentgenograms may allow the surgeon to predict the possibility of postoperative rotation deformity. Key Words: Fracture line, Humerus, Supracondylar, Pediatric, Epicondyle.