For Gartland I supracondylar fractures above-elbow posterior splint for around three weeks typically sufficient: Study

The key findings of the study were:

• Across randomised and observational studies, type I supracondylar fractures rarely displace irrespective of immobilisation. Compared with collar-and-cuff alone, above-elbow posterior splints or back slabs reduce pain, analgesia use, and sleep disturbance, and accelerate return to activity.

• Removable (soft) casts and long-arm splints are non-inferior to rigid long-arm casts for radiographic and functional outcomes, while often improving convenience and parent and patient experience.

• Newer materials (waterproof or hybrid mesh liners, biobased polyester, and 3D printed orthoses) further enhance comfort without compromising stability.

• While a few older or smaller studies exhibited methodological limitations, the overall evidence base is internally consistent, clinically reliable, and methodologically sound for informing non-operative immobilisation of Gartland I supracondylar fractures. The predominant risks relate to small sample sizes and lack of blinding, rather than fundamental flaws in study conduct.

The authors concluded - “For Gartland I supracondylar fractures, immobilisation choice does not affect fracture healing, which is consistently excellent. However, immobilisation does affect pain, function, satisfaction, and convenience. Evidence supports the use of posterior splints or removable long-arm casts as safe, effective, and family- friendly. Collar-and-cuff alone should generally be avoided. Novel materials offer added comfort and practicality, with potential system-level benefits. Clinicians should prioritise good application technique, patient or family education, and pragmatic follow-up. Future research should clarify cost-effectiveness and broader implementation of innovative materials.”

Further reading:

Immobilisation for Gartland I Supracondylar Humerus Fractures in Children: A Systematic Review

Sofia Bitsios et al

Cureus 17(11): e96418. DOI 10.7759/cureus.96418

DOI: 10.7759/cureus.96418