Castañeda LP, Aziz JJ, Atri LJ

Language: Spanish
References: 23
Page: 13-18
PDF size: 145.52 Kb.

ABSTRACT

Background: A deformity in cubitus varus is a well-known complication after a supracondylar fracture of the humerus. The pattern of placement of pins for treatment of these fractures has been the subject of considerable controversy. Objective: To identify the factors associated with the development of cubitus varus after a supracondylar fracture. Patients and methods: We reviewed all cases of supracondylar fractures treated between 1997 and 2002; we identified the pattern of pin placement and results were graded using the Flynn criteria, we also measured the carrying angle with a minimum follow-up of 2 years. Results: 34 patients were reviewed; the average age at the time of fracture was 6.55 years (range 3.1 to 10.1). According the Gartland classification 16 type II fractures were found and 18 type III fractures were founds. Fixation was performed with 2 crossed pins in 26 patients and with 2 lateral entry pins in 8 patients. The average follow-up was 2.3 years (range 2.0 to 7.3). The carrying angle in relation to the unaffected elbow changed from an average of 14.88° to 12.26° (p = 0.045). Three cases of cubitus varus were identified, all had been treated with crossed pins; none of the patients treated with lateral entry pins developed cubitus varus (p = 0.115). The reduction in relative risk was 89%. The overall risk of developing a cubitus varus deformity in this study was 8.8%, with the risk being higher in children over the age of 7, Gartland type III fractures and a crossed pin configuration. Conclusion: The only modifiable variable that can reduce the risk of developing a cubitus varus deformity is the pattern of pin placement, with the 2-pin lateral entry configuration being related to the lowest risk of developing the deformity. Level of evidence: Level IV- case series.

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