Pediatric distal metaphysis fractures of the humerus: etiopathogenesis, clinical features, diagnostics, treatment

Backgrоund. Distal metaphysis fractures of the humerus in children are the most common among elbow joint injuries in children, occurring in 64–70%. Aim. Generalization of literature data and presentation of modern views on epidemiology, etiology, pathogenesis, diagnostics and treatment of supracondylar humeral fractures in children.

Materials and methods. A systematic literature search was conducted using the following databases: PubMed,  PubMed  Central,  Web  of  Science,  Scopus,  MEDLINE,  eLIBRARY,  RINTS,  Google  Scholar, Cyberleninka, eLibrary, etc. The inclusion criteria were publications on fractures of the distal metaphysis of the humerus, treatment of supracondylar fractures of the humerus in children aged 1–17 years.

Results. Distal metaphysis fractures of the humerus are the most common among elbow joint fractures in children. Treatment of non-displaced fractures Gartland type I is  conservative. The preferred method of treatment for displaced fractures Gartland types (II, III and VI) is closed reduction with percutaneous pinning osteosynthesis. In case of unsuccessful attempts to perform closed reduction, or in case of development of serious neurovascularal disorders, open reduction with revision of the fracture area is used. Surgical interventions with osteosynthesis of distal humerus fractures have increased several times in recent years, but the number of corrective osteotomies in the treatment of post-traumatic deformities has significantly decreased.

Conclusions. The correct approach in the diagnostics and treatment of pediatric distal metaphyseal fractures of the humerus, a reasonable choice  of  surgical  treatment  method  and  osteosynthesis  technique  ensure positive treatment results and reduce the risk of complications throughout all stages of the treatment period.

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