These fractures are categorized according to the modified Gartland classification system, depending on the degree of displacement, disruption of the posterior cortex, and location of the anterior humeral capitellum line on a lateral radiograph ( 3). Supracondylar humerus fractures are the most common pediatric elbow fracture ( 1) and account for around 60–70 emergency department visits per 100,000 children annually ( 2). Systematic Review Registration:, identifier. Level of Evidence Level II systematic review of Level II studies. No studies directly compared posterior splints to circumferential casts.Ĭonclusion: There is insufficient high-quality evidence to determine the optimal conservative treatment for patients with Gartland type 1 supracondylar fractures. Two randomized control trials (RCTs) suggested that soft fiberglass casts reduced appointment time and increased parent satisfaction, compared to traditional casts. Two small studies suggested that cuff and collar treatment provided inadequate pain control and delay in return to normal activities, compared to posterior splints. Within the available evidence there were no cases of fracture displacement. The studies were heterogenous, in intervention and outcomes, and all at moderate risk of bias. Results: After duplicate records were removed, 525 records were evaluated with 9 studies meeting the inclusion criteria and 5 reporting clinical outcomes. Risk of bias was assessed using the Newcastle-Ottawa scale, Rob-2, and the ROBINS tools. Outcomes of interest included fracture displacement, pain control, time to return to normal activities, return of range of motion (ROM), child/parent satisfaction, adverse events, and cost. Randomized trials, quasi-experimental trials, and prospective cohort studies were included. Articles were eligible if they included children less than 18 years old, with non-displaced supracondylar fractures, treated non-operatively. An electronic search was performed in November 2020. Methods: The review process was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. This systematic review was performed to gather evidence on the optimal form of immobilization to treat these fractures. Purpose: Gartland Type 1 supracondylar humerus fractures are stable, non-displaced injuries treated with non-operative management. 3Division of Plastic Surgery, Children’s Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada.2Division of Emergency Medicine, Children’s Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada.1Division of Orthopedic Surgery, Children’s Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada.Stephanie Coupal 1 Kenneth Lukas 1 Amy Plint 2 Maala Bhatt 2 Kevin Cheung 3 Kevin Smit 1 Sasha Carsen 1*
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