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The problem of post-traumatic varization of the distal end of the humerus remaining after the recovery of a supracondylar fracture

Bukvić, Nadoa; Kvesić, Anted; Brekalo, Zdrinkod; Bosak, Anaa; Bukvić, Franeb; Karlo, Robertc

Journal of Pediatric Orthopaedics B: July 2013 - Volume 22 - Issue 4 - p 372–375
doi: 10.1097/BPB.0b013e328360f8df
Upper Limb

We aimed to determine whether the distal end of the humerus had the capacity of spontaneous realignment of the remaining deformity following an inadequate reposition of the supracondylar fracture. The results in 56 children with a supracondylar humerus fracture were analysed. In 45 patients (80%), manual repositioning was performed along with transcutaneous fixation, whereas in 11 patients (20%), only manual repositioning and immobilization in plaster cast was applied. Immobilization was removed and physical therapy was started in all patients on the 21st day following the intervention. Anteroposterior and left-lateral radiography was performed and Baumann’s angle was determined. Follow-up radiograph of the elbow of the traumatized and healthy extremity was performed at an interval of 5–15 years (median 9.4). There was no statistically significant difference between the relationship of Baumann’s angle of the injured arm measured on the 21st day after the reduction of fragments on the one hand and the carrying angle of the injured and healthy arm measured at the long-term follow-up on the other (t=0.48, P=0.63). Similarly, there was no statistically significant difference between the relationship of Baumann’s angle of the injured arm measured at the long-term follow-up and the findings of the carrying angle of both the injured and the healthy arm obtained on the same examination (t=0.78, P=0.44). On the basis of our experience, we conclude that there is no biological capacity to rectify a possible remaining postreduction varus deformity by spontaneous remodelling.

aDepartment of Pediatric Surgery, Clinical Hospital Centre

bFaculty of Medicine, University of Rijeka, Rijeka

cDepartment of Pediatric Surgery, General Hospital Zadar, Zadar, Croatia

dDepartment of Pediatric Surgery, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina

Correspondence to Nado Bukvić, Dr Med., MD, Department of Pediatric Surgery, Clinical Hospital Center Rijeka, Istarska 43-A, 51000 Rijeka, Croatia Tel: +385 51 263 837; fax: +385 51 621 420; e-mail: nado.bukvic@optinet.hr

© 2013 by Lippincott Williams & Wilkins, Inc.