Conservative Versus Surgical Treatment of Gartland Type II Supracondylar Humeral Fractures in Children - Which One ?
2026년 4월 26일 업데이트: Ebraheem Ahmed Farouk Abdelraheem, Assiut University
Conservative Versus Surgical Treatment of Gartland Type II Supracondylar Humeral Fractures in Children - Randomized Controlled Trial
The primary aim of this research is to compare the efficacy of conservative treatment versus surgical treatment for Gartland type II supracondylar humerus fractures in children.
The comparison focuses on assessing differences in clinical outcomes functional recovery times, and complication rates between the two treatment groups.
연구 개요
상태
아직 모집하지 않음
정황
상세 설명
Supracondylar Humerus Fractures are the most common type of elbow fracture in children, typically occurring between the ages of five and seven. These injuries are critical due to their proximity to major neurovascular structures, making prompt and appropriate management essential to prevent severe complications. The vast majority (approximately 98%) of SCHFs are extension-type injuries, resulting from a fall onto an outstretched hand with the elbow hyperextended.
Classification: The Gartland System The classification is based on the degree of displacement of the distal fragment relative to the proximal fragment, as seen on a lateral radiograph.
Type I stable, nondisplaced fractures are managed non-operatively.
- Treatment: Immobilization in a long-arm cast or splint for 3 to 4 weeks, typically in 90 degrees of flexion, followed by early mobilization .
- Goal: Pain control and protection from further displacement. Type II FracturesThese fractures are unstable in extension but maintain some stability due to the intact posterior cortex. Management remains a point of controversy, with both conservative and surgical options being utilized.•Conservative Option: Closed reduction (CR) and casting, often reserved for less displaced or stable Type IIA fractures.•Surgical Option: Closed Reduction and Percutaneous Pinning (CRPP) is the preferred surgical method, especially for unstable Type IIB fractures (those with rotational instability).
Type III and IV are highly unstable fractures that require urgent intervention to achieve and maintain reduction .
Treatment: Closed Reduction and Percutaneous Pinning (CRPP) is the mainstay of treatment .Open reduction may be necessary if closed reduction fails or if there is a vascular compromise requiring exploration.
•Goal: Anatomical reduction and stable fixation to prevent malunion and neurovascular complications.
연구 유형
중재적
등록 (추정된)
50
단계
- 해당 없음
참여기준
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자격 기준
공부할 수 있는 나이
- 어린이
건강한 자원 봉사자를 받아들입니다
아니
설명
Inclusion Criteria:
- Patients with Gartland type II supracondylar humerus fractures with age between 1-12 years old treated at the AUH
Exclusion Criteria:
- Gartland Type I, III, or IV fractures.
- Open fractures.
- Associated neurovascular injury (e.g., absent radial pulse, documented nerve palsy).
- Patients with another injury in the same limb
- Pathological fractures.
- Pre-existing elbow pathology or congenital deformity.
- Inability to comply with follow-up protocol.
공부 계획
이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 치료
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 없음(오픈 라벨)
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
|---|---|
|
실험적: Conservative treatment
Children with Gartland type II supracondylar humeral fractures will be treated conservatively using closed reduction followed by immobilization in an above-elbow cast .
Patients will be followed up clinically and radiologically at regular intervals to assess fracture alignment, healing, and functional outcomes.
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Closed reduction of Gartland type II supracondylar humeral fracture under appropriate analgesia or anesthesia, followed by immobilization using an above-elbow cast.
Patients will undergo regular clinical and radiographic follow-up to monitor fracture alignment, healing, and functional recovery.
|
|
실험적: Surgical treatment group
Children will undergo surgical treatment via Closed reduction and percutaneous pinning under general anesthesia.
Postoperative follow-up will include clinical and radiological assessment of fracture healing, alignment, and complications.
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surgical treatment vis Closed reduction and percutaneous pinning under general anesthesia.
Postoperative care includes clinical and radiographic follow-up to assess fracture healing, alignment, and potential complications.
|
연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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Functional outcome assessed by Modified Disabilities of the Arm, Shoulder and Hand (QuickDASH) score
기간: 1 year
|
Functional outcome will be evaluated using the Modified QuickDASH questionnaire.
Scores range from 0 to 100, with higher scores indicating greater disability.
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1 year
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2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Elbow flexion range of motion (degrees)
기간: 1 month, 3 months, and 6 months post-intervention
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Measured in degrees using a goniometer to assess maximum elbow flexion.
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1 month, 3 months, and 6 months post-intervention
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Elbow extension range of motion (degrees)
기간: 1 month, 3 months, and 6 months post-intervention
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Measured in degrees using a goniometer to assess maximum elbow extension.
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1 month, 3 months, and 6 months post-intervention
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Pain assessed using Visual Analog Scale (VAS)
기간: 1 month, 3 months, and 6 months post-intervention
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Pain is measured on a scale from 0 to 10, where 0 indicates no pain and 10 indicates worst possible pain.
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1 month, 3 months, and 6 months post-intervention
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Baumann angle (degrees)
기간: Immediately post-reduction and at 6 months
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Measured on standard anteroposterior elbow radiographs to assess coronal alignment.
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Immediately post-reduction and at 6 months
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Anterior humeral line alignment (normal/abnormal)
기간: Immediately post-reduction and at 6 months
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Assessed on lateral elbow radiographs to evaluate sagittal alignment.
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Immediately post-reduction and at 6 months
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Loss of reduction (yes/no)
기간: Up to 6 months post-intervention
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Defined as displacement of fracture fragments on follow-up radiographs.
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Up to 6 months post-intervention
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Incidence of nerve injury (yes/no)
기간: Up to 6 months post-intervention
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Includes any documented motor or sensory nerve deficit following treatment.
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Up to 6 months post-intervention
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Incidence of infection (yes/no)
기간: Up to 6 months post-intervention
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Includes superficial or deep infection related to treatment.
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Up to 6 months post-intervention
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공동 작업자 및 조사자
여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.
연구 기록 날짜
이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.
연구 주요 날짜
연구 시작 (추정된)
2026년 6월 1일
기본 완료 (추정된)
2028년 6월 1일
연구 완료 (추정된)
2028년 8월 1일
연구 등록 날짜
최초 제출
2026년 4월 18일
QC 기준을 충족하는 최초 제출
2026년 4월 26일
처음 게시됨 (실제)
2026년 4월 30일
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
2026년 4월 30일
QC 기준을 충족하는 마지막 업데이트 제출
2026년 4월 26일
마지막으로 확인됨
2026년 4월 1일
추가 정보
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