Correlation of radiologic scoring and clinical results in patients which are operated for pediatric supracondylar humerus fracture - A propective study

Objective: The aim of this study is to investigate the feasibility of radiographic union scores in supracondylar humeral fractures. In this way, to evaluate the postoperative union in the outpatient clinic controls, to help the surgeon make more objective decisions regarding the timing of the splint removal and the removal of the pins and to investigate the correlation of the scoring with the clinical results. Material Method: A total of 66 patients, 40 males and 26 females, who were admitted to the emergency department or orthopedics outpatient clinic due to supracondylar humerus fracture were included in the study. A pre-operative patient card was created for each patient and their demographic characteristics were recorded. Patients were routinely called for orthopedic outpatient clinic controls at 2, 3, 4, 6 and 8 weeks after surgery. Elbow AP and lateral radiographs were routinely taken to the patients during the outpatient controls. When calculating RUS, the broken cortex line was evaluated on properly drawn radiographs. The grip strength of patients older than 3 years was recorded with a dynamometer. Radiographic elbow angles of the patients were measured. The weekly course of these values was followed. Results: It was observed that the RUS values of the patients increased as the weeks progressed. Fracture union was completed at the 8th week. The condition with which the RUS value is most related is the type of fracture. RUS in the first weeks of type 2 fractures was calculated higher than other fracture types. By the 8th week, similar RUS was calculated in all types of fractures. RUS in the closed reduction fractures was calculated high at the 2nd week. By the 8th week, similar RUS was calculated for closed and open reduction fractures. If we look at the relationship between RUS and surgical technique; A significant difference was found between open and closed surgery and RUS at week 2 (p = 0.023). In other weeks, there was no significant difference between surgical technique and RUS. Conclusion: Supracondylar humerus fractures should be checked at regular intervals after operation and radiographic union and clinical improvement should be seen to ensure full recovery. We think that in patients with RUSSUH value 8 and above, if there is no other situation after clinical evaluation, the splint can be removed and elbow exercises should be started to increase ROM. We think that pins can be removed after clinical evaluation in patients with RUSSUH 10 or above.