Supracondylar fractures of the humerus are frequent paediatric injuries. The aims of this study were to evaluate the applicability and reproducibility of the Gartland and Wilkins classification, the Baumann angle (BA) and the Anterior Humeral Line (AHL). This retrospective monocentric observational study was conducted on 217 patients. Four observers assessed the pre-operative radiographs by applying the Gartland and Wilkins classification and the post-operative X-rays by measuring the BA and AHL. The kappa coefficient (K) and the Cohen’s kappa were used for the reliability of the Gartland classification; the Intraclass Correlation Coefficient (ICC) for that of the BA. The AHL was evaluated in a double manner by using first the K and the Cohen’s kappa and then the ICC. A total of 186 patients were eligible. Inter-observer reliability for the Gartland classification was K = 0.73–0.61 for type III, 0.65–0.61 for type Ia and 0.43–0.26 for type IIb. The Baumann angle mean value in the first data collection was 73.5 ± 6.85 (inter-observer ICC 0.74) and 72.9 ± 6.83 (inter-observer ICC 0.77) for the second data collection; AHL: inter-observer ICC 0.87 for the first evaluation and 0.80 for the second one. Gartland’s classification modified by Wilkins has a high degree of reliability. BA and AHL appear reproducible and reliable.

Fractures of the lateral condyle of the humerus are one of the most common fractures in children, accounting for between 10% and 20% of fractures involving the elbow, with a peak incidence at 6 years of age. Treatment is often surgical for displaced fractures > 2 mm, according to Milch and Jakob classification. There is no consensus in the literature about the appropriate surgical management of these fractures. Objectives: The aim of this study is to describe, propose, and evaluate outcomes and complications of the surgical technique of reduction and osteosynthesis using trans-bone suture with resorbable threads. Methods: Patients with lateral condyle fractures treated with this surgical technique from 2015 to 2019 were included in this retrospective study, with a minimum follow-up of 24 months. For clinical and functional assessment of the elbow, Mayo Elbow Scores were recorded; we assessed the time of fracture healing, carrying angles, and Baumann angle of the affected limb compared to the healthy contralateral elbow for radiographic data. Complications have also been described. Results: We achieved satisfactory results; 36 patients with lateral condyle fractures were included in this study. Radiological healing was achieved in all cases. There was only one complication. No cases required additional surgical procedures. Almost all patients achieved a complete flexion of 110 degrees or more and complete extension. Conclusions: This surgical technique has good functional outcomes and fracture healing, a lower incidence of complications when compared to other surgical techniques, and no mechanical failure with good clinical and radiological results.

Background/Objectives: Pediatric flexible flatfoot is a common developmental variation, and treatment is generally considered when pain or functional limitations are present. This systematic review evaluated clinical and biomechanical evidence for sensorimotor insoles in children with flexible flatfoot and contextualized these findings alongside evidence for conventional foot orthoses and exercise-based rehabilitation; head-to-head comparative evidence was not assumed when unavailable. Methods: Following PRISMA 2020 guidelines, comprehensive searches were performed across PubMed/MEDLINE, the Cochrane Library, and PubMed Central up to August 2026. Eligible primary studies comprised randomized controlled trials, randomized comparative or sequence trials, prospective comparative or pre-post studies, and longitudinal cohort studies evaluating pain, function, gait, balance, posture, or neuromuscular outcomes. Risk of bias was assessed using RoB 2 and ROBINS-I, and the certainty of the evidence was summarized qualitatively using GRADE. Results: Ten main clinical studies met inclusion criteria, including 5 RCTs and 5 non-randomized studies, with follow-up periods ranging from 6 weeks to 2 years. Both customized supportive orthoses and intrinsic muscle exercises consistently reduced pain and improved function in symptomatic children in the short- to medium-term. Direct randomized evidence for sensorimotor insoles suggests potential functional and neuromuscular effects; however, the limited evidence base does not support firm conclusions about comparative effectiveness or superiority over supportive orthoses. Evidence for permanent structural arch correction was not established. Conclusions: In symptomatic pediatric flexible flatfoot, conservative treatment should prioritize pain and function. Conventional supportive orthoses and targeted exercise have a broader evidence base, whereas current evidence is insufficient to establish the superiority of sensorimotor insoles.