Differences in Carrying Angle, Baumann’s Angle, Anterior Humeral Line and Dash Score between Children in the Age Group of Less than 5 Years and over 5 Years at 3 Months Post Open Reduction Internal Fixation Criss-Cross Wire Fracture Supracondylar Humerus Gartland Type III

Abstract

Introduction: Supracondylar humerus fracture is one of the most found fractures in children. In addition to adequate fixation, the role of age differences in the clinical outcomes of operative treatment of supracondylar humeral fractures is still a matter of debate. This study aimed to compare the clinical and radiological outcome of surgery in cases of Gartland type III supracondylar humerus fracture. Materials and Methods: This study used a cross-sectional design on the population of patient with Gartland type III supracondylar fracture. Patients were divided into 2 groups: age <5 years old (Group 1) and >5 years old (Group 2). The evaluation was carried out 3 months after surgery with open reduction internal fixation crisscross wire. The parameters assessed were Baumann’s angle, carrying angle, and anterior humeral line, and Disabilities of the Arm, Shoulder, and Hand (DASH) Score.  Difference between group were analyzed using the chi-square test. Results: There were a total of 34 patients included in this study. Patients >5 years old had a 1.85 times greater chance to have a post-operative carrying angle of >15o (95% CI 0.993-3.474; p = 0.037) and 2.75 times greater chance to result in post-operative Baumann’s angle >80o (95% CI 1,089-6,943, p=0.037). There were no significant differences in anterior humeral line (p=1) and DASH score (p=0.244) between groups. Conclusion: The result of surgery in supracondylar fracture of the humerus over 5 years old tend to have worse radiological outcome (carrying angle and Baumann’s angle) than patient younger than 5 years old. Thus, treatment of supracondylar fractures of the humerus aged more than 5 years requires more attention with adequate reduction and vigilance against complications that can affect the bone growth of pediatric patients.