Double joystick technique – a modified method facilitates operation of Gartlend type-Ⅲ supracondylar humeral fractures in children

Abstract

Gartland type-Ⅲ supracondylar humerus fracture (SCHF) is a severe lesion with the feature of difficult reduction. Due to the high failure rate of traditional reduction, a more practical and safer method is needed. This retrospective study aimed to explore the effectiveness of the double joystick technique during the closed reduction of children with type-III fractures. Forty-one children with Gartland type-Ⅲ SCHF underwent closed reduction and percutaneous fixation using the double joystick technique at our hospital between June 2020 and June 2022, and 36 (87.80%) patients were successfully followed up. The affected elbow was evaluated by the joint motion, radiographs, and Flynn’s criteria then contrasted with the contralateral elbow at the last follow-up. A group of 29 boys and seven girls with an average age of 6.33 ± 2.68 years. The mean time of surgery and hospital stay was 26.61 ± 7.51 min and 4.64 ± 1.23 days, respectively. After a mean follow-up of 12.85 months, the average Baumann angle was 73.43 ± 3.78°, although the average carrying angle (11.33 ± 2.17°), flexion angle (143.03 ± 5.15°), and extension angle (0.89 ± 3.23°) of the affected elbow were less than those of the contralateral elbow (P < 0.05), the mean range of motion difference between two sides is only 3.39 ± 1.59°, with no complications. Furthermore, 100% of patients recovered satisfactorily, with excellent outcomes (91.67%) and good outcomes (8.33%). The double joystick technique is a safe and effective method that facilitates the closed reduction of Gartland type-Ⅲ SCHF in children without raising the risk of complications.