[Indications for the surgical and conservative treatment of juvenile supracondylar humeral fractures and their results].

In the period from 1977 to 1982 78 children were treated for supracondylar fractures of the humerus at the Berufsgenossenschaftliche Unfallklinik Frankfurt/Main. Indications and methods for operative and conservative treatment are described. The results of therapy were reviewed by means of a questionnaire or reexamination in 68 patients with regard to function, elbow deformity and nerve lesions. Fractures of a grade I severity are to be treated conservatively by immobilisation in a POP-cast. Only in exceptional cases of grade II severity can a closed reduction be recommended. All remaining types of fractures of grade II and III severity should primarily be treated by open operations within 8 hours of the accident. Under these conditions the risk of infection is no higher than with percutaneous Kirschner-wire-osteosynthesis. Complications such as appreciable varus deformity, poor function and nerve lesions can largely be avoided in this way. The so-called extension-treatment offers no advantages in comparison with operative treatment.