From the Guidelines
Management of Displaced Humerus Fractures in Infants
The management of displaced humerus fractures in infants typically involves closed reduction with pin fixation for patients with displaced fractures, as recommended by the American Academy of Orthopaedic Surgeons (AAOS) guideline 1.
- This approach is suggested for patients with displaced (eg, Gartland types II and III and displaced flexion) pediatric supracondylar fractures of the humerus.
- The closed reduction with pin fixation method is supported by moderate strength of recommendation, based on evidence from nine level III studies and two level II studies 1.
- The goal of treatment is to achieve and maintain anatomical alignment of the fracture, while minimizing discomfort and promoting healing.
- Pain management is also an essential aspect of treatment, and may involve the use of medications such as acetaminophen or ibuprofen, although the specific dosing and treatment duration may vary depending on the individual case.
- Close follow-up with serial radiographs is crucial to monitor fracture alignment and healing, and to ensure that the treatment plan is effective.
From the Research
Management of Displaced Humerus Fracture in Infants
- The management of displaced humerus fractures in infants is crucial to prevent long-term complications and ensure proper healing.
- According to 2, displaced fractures (Types 2,3, and 4) are usually managed surgically, whereas non-displaced fractures (Type 1) can be managed non-operatively.
- A study by 3 found that minimally displaced pediatric humerus lateral condyle fractures have a high risk of failure when managed non-operatively, and early operative management may be necessary.
Treatment Options
- Closed reduction and percutaneous pinning is a common treatment method for displaced humerus fractures in children, as reported by 4.
- However, this method has been associated with a higher incidence of complications, such as cubitus varus, and longer operative and healing times.
- Other treatment options, such as elastic stable intramedullary nails and miniplate fixation, may have better outcomes and shorter healing times, as seen in 4.
Assessment and Management
- A thorough initial assessment, including vascular and neurological examinations, is essential to identify any associated injuries, as emphasized by 5.
- Immobilization in plaster is a common treatment method for pediatric supracondylar fractures of the humerus, but it is crucial to follow up with orthogonal radiographs and repeat neurovascular assessments.
- The use of MRI can be beneficial in evaluating non-displaced lateral humeral condyle fractures in children, as it can help determine whether the fracture is complete or incomplete, as reported by 6.