A 5-year-old boy falls on his outstretched hand and presents with a supracondylar fracture of the humerus. The anterior humeral line on lateral X-ray passes through the anterior third of the capitellum. Extension type Gartland grade II fracture is diagnosed. The treatment of choice is:

• A Collar and cuff for 3 weeks
• B Open reduction and internal fixation via anterior approach
• C Closed reduction and percutaneous K-wire fixation under image intensifier ✓
• D Skin traction for 2 weeks followed by collar and cuff

Explanation

Gartland II supracondylar fractures have an intact posterior periosteal hinge with some displacement/angulation (anterior humeral line passing anterior to capitellum center). Standard treatment is closed reduction and percutaneous K-wire fixation (CRPP) under fluoroscopy. Two lateral-entry or crossed K-wires (one lateral, one medial — being cautious of ulnar nerve) provide stable fixation allowing early mobilization. Collar-and-cuff alone risks redisplacement and cubitus varus. Open reduction is reserved for failed closed reduction or vascular injury. CRPP has replaced traction as the gold standard due to better outcomes and shorter hospital stay.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.