FRATURAS SUPRACONDILIANAS INFANTIS: REVISÃO SISTEMÁTICA DE OPÇÕES DE TRATAMENTO

Higuchi, Douglas Hideo; Oliveira, Gabriel Alencar de; Alves, João Paulo; Lebedenco, Lucas; Dobashi, Eiffel Tsuyoshi

Douglas Hideo Higuchi Correspondence: Douglas Hideo Higuchi. Rua Sena Madureira, 80, Vila Clementino, São Paulo, SP, Brazil, 04021-050. douglas_higuchi@hotmail.com

Each author contributed individually and significantly to the development of this article

Universidade Federal de São Paulo – UNIFESP, Escola Paulista de Medicina, Departamento de Ortopedia e Traumatologia, São Paulo, SP, Brasil.

https://orcid.org/0009-0006-6255-8108

Gabriel Alencar de Oliveira

Each author contributed individually and significantly to the development of this article

Universidade Federal de São Paulo – UNIFESP, Escola Paulista de Medicina, Departamento de Ortopedia e Traumatologia, São Paulo, SP, Brasil.

https://orcid.org/0009-0007-6187-1925

João Paulo Alves

Each author contributed individually and significantly to the development of this article

Universidade Federal de São Paulo – UNIFESP, Escola Paulista de Medicina, Departamento de Ortopedia e Traumatologia, São Paulo, SP, Brasil.

https://orcid.org/0009-0008-0430-7567

Lucas Lebedenco

Each author contributed individually and significantly to the development of this article

Universidade Federal de São Paulo – UNIFESP, Escola Paulista de Medicina, Departamento de Ortopedia e Traumatologia, São Paulo, SP, Brasil.

https://orcid.org/0009-0002-9308-6423

Eiffel Tsuyoshi Dobashi

Each author contributed individually and significantly to the development of this article

Universidade Federal de São Paulo – UNIFESP, Escola Paulista de Medicina, Departamento de Ortopedia e Traumatologia, São Paulo, SP, Brasil.

https://orcid.org/0000-0001-6735-1401

Correspondence:
Douglas Hideo Higuchi. Rua Sena Madureira, 80, Vila Clementino, São Paulo, SP, Brazil, 04021-050. douglas_higuchi@hotmail.com

All authors declare no potential conflict of interest related to this article.

Jadad Evaluation. ⁹9. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, et al. Assessing the quality of reports of randomized clinical trials: Is blinding necessary? Control Clin Trials. 1996;17(1):1-12.	Afaque et al. ⁷7. Afaque SF, Singh A, Maharjan R, Ranjan R, Panda AK, Mishra A. Comparison of clinic-radiological outcome of cross pinning versus lateral pinning for displaced supracondylar fracture of humerus in children: A randomized controlled trial. J Clin Orthop Trauma. 2019;11(2):259-63	Jain et al. ¹¹11. Claireaux H, Goodall R, Hill J, Wilson E, Coull P, Green S, et al. Multicentre collaborative cohort study of the use of Kirschner wires for the management of supracondylar fractures in children. Chin J Traumatol. 2019;22(5):249-54.	Natalin et al. ¹²12. Jain DrS, Agrawal DrS, Banshiwal DrR. Comparative study of posterior intrafocal with lateral pinning versus cross pinning for extension type supracondylar fracture humerus in children. National Journal of Clinical Orthopaedics. 2019;3(1):134-9.	Othman et al. ¹³13. Natalin HM, da Silva JCS, Volpon JB. Comparison of two methods of fixation of supracondylar fractures of the humerus in children. Acta Ortop Bras. 2021;29(5):263-7.
Was the study described as randomized?	1	0	0	0
Was randomization described and was it adequate?	1	1	1	1
Was the study described as double-blind?	0	0	0	0
Was blinding described and was it appropriate?	0	0	0	0
Were losses and exclusions been described?	1	1	1	1
Total:	3	2	2	2

Author/ Year	Study follow-up time	MINORS Score ²¹21. Anvekar PM, Nimbargi SS, Akshay MK et al. A prospective study of surgical management of the displaced supracondylar fractures of humerus in children with k wire fixation. International Journal of Orthopaedics Sciences. 2017;3(3):176-81.
Claireaux et al. ¹⁰10. Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J. Methodological index for non-randomized studies (minors): development and validation of a new instrument. ANZ J Surg. 2003;73(9):712-6.	24 weeks	6
Yawar et al. ¹⁴14. Othman M, Nahla A, El-Malt A. A comparative study of three percutaneous pinning techniques for paediatric supracondylar humeral fractures. ARC Journal of Orthopedics. 2017;2(2):11-9.	24 weeks	9
Rutuarama and Firth ¹⁵15. Yawar B, Khan MN, Asim A, Qureshi A, Yawar A, Faraz A, McAdam A, Mustafa S, Hanratty B. Comparison of lateral and crossed k-wires for paediatric supracondylar fractures: a retrospective cohort study. Cureus. 2022;14(7):e27267.	24 weeks	12
Trung et al. ¹⁶16. Rutarama A, Firth GB. Assessment of elbow functional outcome after closed reduction and percutaneous pinning of displaced supracondylar humerus fractures in children. SA Orthop J. 2019;18(4).	48 weeks	6
Agrawal et al. ¹⁷17. Trung DT, Van NL, Huu VN, Nguyen CD, Ngoc HN, Nga VT, et al. Closed Reduction and Percutaneous Pinning for Supracondylar Fractures of Humerus in Vietnamese Children. Open Access Maced J Med Sci. 2019;7(24):4194-98.	24 weeks	10
Moratelli et al. ¹⁸18. Agrawal S, Parida SK, Das A. A comparison of the functional results following closed reduction of displaced paediatric supracondylar humerus fractures mended with two lateral or crossed percuteneous kirschner-wire. International Journal of Pharmaceutical and Clinical Research. 2023;15(3):313-8.	8 weeks	10
Li et al. ¹⁹19. Moratelli L, Santarosa HM, Katayama AY, Belangero WD. Influence of time to surgery and pin fixation (lateral or crossed) on Flynn’s criteria in Gartland type II and III supracondylar fracture: A retrospective study on 129 patients. Journal of Musculoskeletal Surgery and Research. 2019;3(3):342. Available from: https://journalmsr.com/influence-of-time-to-surgery-and-pin-fixation-lateral-or-crossed-on-flynns-criteria-in-gartland-type-ii-and-iii-supracondylar-fracture-a-retrospective-study-on-129-patients/ https://journalmsr.com/influence-of-time...	60 weeks	11

Author/ Year	Sample	Type of Fracture	Intervention	Follow-up (weeks)	Outcome
Claireaux et al. ¹⁰10. Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J. Methodological index for non-randomized studies (minors): development and validation of a new instrument. ANZ J Surg. 2003;73(9):712-6.	N: 209 patients 52.0% girls 6.4 years on average	Gartland Type II or III	Different diameters Kirschner crossed wires	24	Significant loss of reduction and neurological deficit were observed.
Afaque et al. ⁷7. Afaque SF, Singh A, Maharjan R, Ranjan R, Panda AK, Mishra A. Comparison of clinic-radiological outcome of cross pinning versus lateral pinning for displaced supracondylar fracture of humerus in children: A randomized controlled trial. J Clin Orthop Trauma. 2019;11(2):259-63	N: 84 patients 70.0% boys 6.8 years on average	Gartland Type III	Crossed fixation Lateral fixation	12	Both techniques provided stable fixation and good functional results without iatrogenic injuries to the ulnar nerve.
Jain et al. ¹¹11. Claireaux H, Goodall R, Hill J, Wilson E, Coull P, Green S, et al. Multicentre collaborative cohort study of the use of Kirschner wires for the management of supracondylar fractures in children. Chin J Traumatol. 2019;22(5):249-54.	N: 168 patients 70.2% boys 6.8 years on average	Gartland Type III	Crossed fixation Lateral fixation	24	Both groups showed a significant loss of range of motion and the cross-fixation group, iatrogenic nerve injuries.
Natalin et al. ¹²12. Jain DrS, Agrawal DrS, Banshiwal DrR. Comparative study of posterior intrafocal with lateral pinning versus cross pinning for extension type supracondylar fracture humerus in children. National Journal of Clinical Orthopaedics. 2019;3(1):134-9.	N: 43 65.0% boys 6.5 years on average	Gartland Type III	Crossed fixation Lateral fixation	8	Observed neither compartment syndrome, vascular or treatment-related nerve injuries nor pin infections.
Othman et al. ¹³13. Natalin HM, da Silva JCS, Volpon JB. Comparison of two methods of fixation of supracondylar fractures of the humerus in children. Acta Ortop Bras. 2021;29(5):263-7.	N: 47 Sex: unreported 5.5 years on average	Gartland Type II or III	Dorgan’s Cross Lateral Fixation Medial-lateral cross fixation Parallel or divergent side fixation	28	The aesthetic clinical result was satisfactory for the three techniques in more than 90% of the cases.
Yawar et al. ¹⁴14. Othman M, Nahla A, El-Malt A. A comparative study of three percutaneous pinning techniques for paediatric supracondylar humeral fractures. ARC Journal of Orthopedics. 2017;2(2):11-9.	50 patients 52.0% boys 6.3 years on average	Gartland Type II or III	Crossed fixation Lateral fixation	24	Both lateral and crossed wire configurations led to good radiological stability.
Rutuarama and Firth ¹⁵15. Yawar B, Khan MN, Asim A, Qureshi A, Yawar A, Faraz A, McAdam A, Mustafa S, Hanratty B. Comparison of lateral and crossed k-wires for paediatric supracondylar fractures: a retrospective cohort study. Cureus. 2022;14(7):e27267.	N: 38 66.0% boys 7.5 years on average	Gartland Type III	Closed reduction and Kirschner crossed percutaneous wires	24	Most children regained full range of motion after closed reduction and fixation of crossed wires without physical therapy.
Trung et al. ¹⁶16. Rutarama A, Firth GB. Assessment of elbow functional outcome after closed reduction and percutaneous pinning of displaced supracondylar humerus fractures in children. SA Orthop J. 2019;18(4).	N: 42 70.0% boys 6.0 years on average	Gartland Type II or III	Cross-pining technique with a Kirschner wire inserted medially and another laterally	48	Closed reduction and percutaneous fixation proved to be an effective treatment with good therapeutic results.
Agrawal et al. ¹⁷17. Trung DT, Van NL, Huu VN, Nguyen CD, Ngoc HN, Nga VT, et al. Closed Reduction and Percutaneous Pinning for Supracondylar Fractures of Humerus in Vietnamese Children. Open Access Maced J Med Sci. 2019;7(24):4194-98.	N: 70 65.4% boys 8.0 years on average	Gartland Type II or III	Closed reduction and fixation by two Kirschner crossed wires.	24	Satisfactory functional results, brief hospital stays, and few complications of percutaneous fixation with Kirshner crossed wires.
Moratelli et al. ¹⁸18. Agrawal S, Parida SK, Das A. A comparison of the functional results following closed reduction of displaced paediatric supracondylar humerus fractures mended with two lateral or crossed percuteneous kirschner-wire. International Journal of Pharmaceutical and Clinical Research. 2023;15(3):313-8.	N: 129 59.7% boys 6.3 years on average	Gartland Type II or III	Crossed fixation Lateral fixation	8	Lateral or cross fixation and time to surgery failed to influence the functional outcomes of supracondylar fracture in children but lateral fixation decreases the risk of ulnar nerve injuries.
Li et al. ¹⁹19. Moratelli L, Santarosa HM, Katayama AY, Belangero WD. Influence of time to surgery and pin fixation (lateral or crossed) on Flynn’s criteria in Gartland type II and III supracondylar fracture: A retrospective study on 129 patients. Journal of Musculoskeletal Surgery and Research. 2019;3(3):342. Available from: https://journalmsr.com/influence-of-time-to-surgery-and-pin-fixation-lateral-or-crossed-on-flynns-criteria-in-gartland-type-ii-and-iii-supracondylar-fracture-a-retrospective-study-on-129-patients/ https://journalmsr.com/influence-of-time...	N: 83 73.5% boys 10.0 years on average	Gartland Type III	Small medial approach and cross-fixation with three Kirschner wires.	60	Low incidence of complications in older children.

[1] Correspondence:
Douglas Hideo Higuchi. Rua Sena Madureira, 80, Vila Clementino, São Paulo, SP, Brazil, 04021-050. douglas_higuchi@hotmail.com

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FRATURAS SUPRACONDILIANAS INFANTIS: REVISÃO SISTEMÁTICA DE OPÇÕES DE TRATAMENTO

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