Abstract
BACKGROUND: This study aims to compare the radiological and functional outcomes of long arm casting versus splinting in the nonsurgical treatment of pediatric supracondylar humerus fractures classified as Modified Gartland type I and IIa. METHODS: Between January 2021 and January 2024, 112 pediatric type I and IIa supracondylar humerus fractures (SCHFs) treated nonoperatively with long arm splinting or casting were evaluated. Baumann angle and lateral capitellohumeral angle (LCHA) were measured pre-reduction, post-reduction, and at weeks 1 and 4. Outcomes were compared using Flynn's criteria. RESULTS: Of the 112 patients, 55 had type I (49%) and 57 had type IIa (51%) fractures (mean age: 7.51 years; 69 males, 43 females). Fractures were equally distributed between the right and left sides (n=56 each). Fifty-eight patients were treated with long arm splinting and 54 with long arm casting. Follow-up durations were similar between groups. In the splint group, the mean Baumann angle was 72.1° pre-reduction and 73.2° at week 4; in the cast group, it was 70.7° and 73.4°, respectively. Mean LCHA increased from 43.9° to 50.8° with splinting and from 42.4° to 50.1° with casting. A statistically significant difference was not observed for loss of reduction between the splinting and casting groups (p=0.475). No statistically significant differences were observed in LCHA (p=0.175), Baumann angle values (p=0.485), or Flynn scores (p=0.768) pre- and post-reduction in type I and type IIa SCHFs. CONCLUSION: Splinting and casting yielded comparable clinical and radiological outcomes in nonsurgically managed Modified Gartland type I and IIa supracondylar humerus fractures. However, splinting stands out as a strong alternative due to its ease of application and lower complication rates.