Background: Gartland type III pediatric supracondylar humerus fractures can be unstable and prone to loss of reduction. The Internal Rotational Stress Test (IRST) aims to assess and address rotational instability during surgery. Method: This retrospective study analyzed treatments for Gartland type III pediatric supracondylar humerus fractures at our institution from January 2020 to December 2022. Only patients who underwent IRST were included. IRST was performed after inserting either two or three lateral pins. Patients were divided into Group 1 (IRST +) or 2 (IRST −) based on IRST results. Radiographic and clinical outcomes were compared between the two groups. Result: A total of 46 patients were included in the study. The mean age at the time of diagnosis was 5.7 years (range, 4 to 11 years), and the mean duration of follow-up was 2.8 years (range, 1.0 to 4.8 years). Group 1 consisted of 24 patients, and Group 2 comprised 22 patients. We did not find any differences in radiographic parameters and clinical scores between the two groups. Additionally, in both groups, there were no instances of major loss of reduction, defined as greater than 12 degrees or 12%. In five patients, we identified two types of fracture patterns that were stable with only two lateral pins. Conclusions: In patients with Gartland type III supracondylar humerus fractures, if reduction is adequately achieved and sufficient fixation force is maintained, the IRST results do not significantly impact radiologic and clinical outcomes. The pattern of the fracture can influence instability, necessitating further research on this matter.
Background/Objectives: Enchondroma, the most common benign cartilage tumor in the hand, often presents as pain, swelling, or pathological fractures. While curettage is the standard treatment preventing fractures, the optimal way of managing the bone cavity remains debated. In this study, we investigated the impact of a filled bone defect on radiologic and clinical outcomes among patients with enchondroma. Methods: We retrospectively reviewed patients with solitary enchondroma of the hand who underwent curettage followed by allogeneic cancellous bone chip impaction grafting. The patients were divided into two groups based on the extent to which their bone defects were filled post-curettage: Group 1 (complete filling) and Group 2 (incomplete filling, i.e., <50%). We reviewed demographic data, local recurrence data, complications, information on consolidation duration, data on range of motion (ROM), and functional scores. Results: This study included 59 patients (25 males and 34 females; mean age, 30.4 ± 11.9 years, with a range of 8–78). Group 1 contained 35 patients, and Group 2 contained 24. No nonunion occurred following curettage and grafting. The mean radiological consolidation period was 6.4 weeks (range: 5–18). There was no significant difference in consolidation time between Group 1 (6.8 weeks) and Group 2 (6.9 weeks) (p = 0.166). The ROM and functional scores also showed no significant differences between the groups, with musculoskeletal society scores of 98.8 for Group 1 and 99.8 for Group 2 (p = 0.63). Conclusions: This study demonstrates that the use of the impaction technique combined with cancellous allochip bone grafting yields favorable results in the treatment of solitary hand enchondroma. The extent to which the bone defect was filled did not significantly impact the overall outcomes.