Fractura supracondílea del codo y el mito de la rotación del fragmento distal

Abstract

The main concern in treating supracondylar fractures of the elbow in the child is to control the rotation of the distal fragment. When the doctor detects the rotation, to achieve the reduction the proximal fragment must be controlled, placing the shoulder in an anatomical position and performing the maneuver. Our objective is to show that in the supracondylar fractures of the humerus in the child, the fragment that rotates is the proximal and not the distal, as has been argued.

Material and method

We conducted a prospective study in 72 pediatric patients, out of 150 who came to the emergency room with supracondylar elbow fractures; Grades II-B and III of Gartland, which showed rotation on the radiograph. We performed AP and strict side radiographs and a 3D CAT of the shoulder and elbow. The diameters of the distal end of the proximal fragment and the proximal end of the distal fragment were measured and compared in each patient. The relationship between rotated fractures, fracture type and lateral or medial displacement was sought.