Treatment for the Supracondylar Fractures of the Distal Humerus with Cannulated Screw

Jin Soo Park; Young Khee Chung; Jung Han Yoo; Kyu Cheol Noh; Kook Jin Chung; Dong Nyoung Lee

doi:10.12671/jkfs.2007.20.1.58

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Park, Chung, Yoo, Noh, Chung, and Lee: Treatment for the Supracondylar Fractures of the Distal Humerus with Cannulated Screw

Original Article

Journal of the Korean Fracture Society 2007; 20(1): 58-63.

Published online: 14 June 2016

DOI: https://doi.org/10.12671/jkfs.2007.20.1.58

Treatment for the Supracondylar Fractures of the Distal Humerus with Cannulated Screw

Jin Soo Park, M.D., Young Khee Chung, M.D., Jung Han Yoo, M.D., Kyu Cheol Noh, M.D., Kook Jin Chung, M.D., Dong Nyoung Lee, M.D.

Department of Orthopaedic Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.

Address reprint requests to: Jin Soo Park, M.D. Department of Orthopaedic Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 948-1, Daerim 1-dong, Yeongdeungpo-gu, Seoul 150-950, Korea. Tel: 82-2-829-5313, Fax: 82-2-834-1728, nyjspark@yahoo.co.kr

Abstract

Purpose

To evaluate the results of the treatment of the supracondylar fractures of the humerus according to the fixation methods with cannulated screw.

Materials and Methods

Eight patients, aged 49 to 82 years (average, 65 years), were reviewed after a mean follow-up of 16 months (range, 12~24 months). According to AO classification all fractures were classified as type A2 (simple transverse supracondylar fracture). All patients underwent closed reduction. Percutaneous fixation with cannulated screws was performed in 8 patients. Three of 8 patients had associated medical problems and one patient had distal radius fracture. The functional results were assessed by the Mayo Elbow Performance Score.

Results

Mean operation time was 59 minutes (45~75) and all the patients with cannulated screw fixation had bony union and were able to early ROM exercise. Mean ranges of motion was 5~120 degrees with excellent functional results. Functional evaluation of elbow joint by Mayo method showed mean value of 88 (75~95).

Conclusion

The cannulated screw fixation of supracondylar fracture of humerus, especially in the elderly aged group with medical disease had excellent functional results (rigid fixation & early ROM exercise) due to shortening of surgery time and anesthesic time, combined with decreased technical difficulties of the surgical procedure.

Keywords: Humerus, Supracondylar, Fracture, Cannulated screw

Figures and Tables

Fig. 1

(A) Preliminary K-wires are inserted from the lowest point of each condyle across the fracture site thereby purchasing bone masses as much as possible.

(B) K-wires should be parallel to each other and the portion of the K-wires in the distal fragment should be located in the circular part (black dotted line) of the tear drop in lateral radiograph of the elbow in order not to encroach either into the trochlear fossa or olecranon fossa.

Fig. 2

(A) A 80 year old woman sustained a A2 type fracture of left distal humerus.

(B) Closed reduction and percutaneous fixation with full threaded cannulated screws was performed.

(C) Sixteen months postoperatively, stable bony union with nearly full range of motion was possible.

Table 1

Patient data

Tr-op: Time interval between trauma and operation (days), ROM: Range of motion, Score: Mayo elbow performance score.

Table 2

Mayo elbow performance score

Classification; Excellent: 90, Good: 75~89, Fair: 60~74, Poor: <60.

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