Benefits of using the shaft condylar angle as a guide for close reduction in pediatric supracondylar humeral fractures

Purpose: The surgical treatment of Gartland types two and three supracondylar humeral fractures is currently recommended. However, post-operative decreases in the range of motion of the elbow are commonly observed. The purpose of this study was to investigate the relationship between shaft condylar...

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Main Authors: Pawaris Sukvanich, Chanavee Jirapornkul, Ronnachit Boonprasert, Pinkawas Kongmalai
Format: Article
Language:English
Published: Elsevier 2025-04-01
Series:Journal of Orthopaedic Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2773157X24002261
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author Pawaris Sukvanich
Chanavee Jirapornkul
Ronnachit Boonprasert
Pinkawas Kongmalai
author_facet Pawaris Sukvanich
Chanavee Jirapornkul
Ronnachit Boonprasert
Pinkawas Kongmalai
author_sort Pawaris Sukvanich
collection DOAJ
description Purpose: The surgical treatment of Gartland types two and three supracondylar humeral fractures is currently recommended. However, post-operative decreases in the range of motion of the elbow are commonly observed. The purpose of this study was to investigate the relationship between shaft condylar angle angle (SCA) and lateral capitellohumeral angle (LCHA) with post-operative range of motion in surgically treated supracondylar humeral fractures. Methods: Patients under the age of 11 with a Gartland type two or three supracondylar humeral fracture who underwent surgery between March 2020 and March 2023 at a tertiary care institution were eligible for this study. Six weeks after surgery, the pediatric orthopedist assessed the range of motion in both the operated and uninjured elbows in terms of flexion and extension. The SCA and LCHA were then measured by the pediatric orthopedist and an orthopedic resident. The measurements were repeated four weeks later. Results: A significant correlation was observed between SCA and elbow flexion in 36 individuals. Subgroup analysis revealed that a difference in SCA of 7.65° from the normal value was associated with a significant difference in the angle of elbow flexion at 6 weeks after surgery. The measurement's reliability was determined to be good for both intra- and inter-observer reliability. Conclusions: The results of this study indicate that SCA is correlated with post-operative loss of elbow flexion and can be used as a tool for post-reduction evaluation. To minimize the loss of elbow flexion after surgery, the SCA should be within 7.65 degrees of the normal value.TCTR20220430007 (Registered 30 April 2022) “retrospectively registered”
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spelling doaj-art-2bd3e0c10cab4cbcba2ca924066552b42025-08-20T02:39:28ZengElsevierJournal of Orthopaedic Reports2773-157X2025-04-014110053110.1016/j.jorep.2024.100531Benefits of using the shaft condylar angle as a guide for close reduction in pediatric supracondylar humeral fracturesPawaris Sukvanich0Chanavee Jirapornkul1Ronnachit Boonprasert2Pinkawas Kongmalai3Department of Orthopaedics, Faculty of Medicine, Srinakharinwirot University, 62 Moo 7, Rangsit-Nakhon Nayok Road, Ongkharak, Nakhon Nayok, 26120, ThailandDepartment of Orthopaedics, Faculty of Medicine, Srinakharinwirot University, 62 Moo 7, Rangsit-Nakhon Nayok Road, Ongkharak, Nakhon Nayok, 26120, ThailandDepartment of Orthopaedics, Faculty of Medicine, Srinakharinwirot University, 62 Moo 7, Rangsit-Nakhon Nayok Road, Ongkharak, Nakhon Nayok, 26120, ThailandFaculty of Medicine, Kasetsart University, 50, Ngamwongwan Road, Lat Yao, Chatuchak, Bangkok, 10900, Thailand; Corresponding author.Purpose: The surgical treatment of Gartland types two and three supracondylar humeral fractures is currently recommended. However, post-operative decreases in the range of motion of the elbow are commonly observed. The purpose of this study was to investigate the relationship between shaft condylar angle angle (SCA) and lateral capitellohumeral angle (LCHA) with post-operative range of motion in surgically treated supracondylar humeral fractures. Methods: Patients under the age of 11 with a Gartland type two or three supracondylar humeral fracture who underwent surgery between March 2020 and March 2023 at a tertiary care institution were eligible for this study. Six weeks after surgery, the pediatric orthopedist assessed the range of motion in both the operated and uninjured elbows in terms of flexion and extension. The SCA and LCHA were then measured by the pediatric orthopedist and an orthopedic resident. The measurements were repeated four weeks later. Results: A significant correlation was observed between SCA and elbow flexion in 36 individuals. Subgroup analysis revealed that a difference in SCA of 7.65° from the normal value was associated with a significant difference in the angle of elbow flexion at 6 weeks after surgery. The measurement's reliability was determined to be good for both intra- and inter-observer reliability. Conclusions: The results of this study indicate that SCA is correlated with post-operative loss of elbow flexion and can be used as a tool for post-reduction evaluation. To minimize the loss of elbow flexion after surgery, the SCA should be within 7.65 degrees of the normal value.TCTR20220430007 (Registered 30 April 2022) “retrospectively registered”http://www.sciencedirect.com/science/article/pii/S2773157X24002261SCALCHASupracondylar fractureElbow ROMReduction guidance
spellingShingle Pawaris Sukvanich
Chanavee Jirapornkul
Ronnachit Boonprasert
Pinkawas Kongmalai
Benefits of using the shaft condylar angle as a guide for close reduction in pediatric supracondylar humeral fractures
Journal of Orthopaedic Reports
SCA
LCHA
Supracondylar fracture
Elbow ROM
Reduction guidance
title Benefits of using the shaft condylar angle as a guide for close reduction in pediatric supracondylar humeral fractures
title_full Benefits of using the shaft condylar angle as a guide for close reduction in pediatric supracondylar humeral fractures
title_fullStr Benefits of using the shaft condylar angle as a guide for close reduction in pediatric supracondylar humeral fractures
title_full_unstemmed Benefits of using the shaft condylar angle as a guide for close reduction in pediatric supracondylar humeral fractures
title_short Benefits of using the shaft condylar angle as a guide for close reduction in pediatric supracondylar humeral fractures
title_sort benefits of using the shaft condylar angle as a guide for close reduction in pediatric supracondylar humeral fractures
topic SCA
LCHA
Supracondylar fracture
Elbow ROM
Reduction guidance
url http://www.sciencedirect.com/science/article/pii/S2773157X24002261
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