| Citation: Barik S, Singh G, Singh V. Reply to Letter to the Editor Regarding the Article: “Preoperative Prediction of Gartland IV Supracondylar Fractures of the Humerus: Is it Possible?”. 57(05):898. doi:10.1055/s-0042-1742601 |
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Conflict of interests The authors have no conflict of interests to declare. |
| Received: October 12 2021; Accepted: November 22 2021 |
To the Editor,
It was a delight to go through a critical analysis of the article by Barik et al.1 The findings in the study are not in tune with the previously published studies on multidirectional unstable supracondylar humerus fracture.2,3
The fractures are known to be created iatrogenically during intraoperative reduction of type III Gartland supracondylar humerus fractures.2 It has been highlighted by Barik et al.1 that the competency of the operating surgeon can play an important role in the creation of these type IV fractures. The discrepancy noted in the rate of neurovascular status of type IV fractures may be attributed to the sample size, compared with that of other studies. We agree that the management protocol as envisaged by Flynn et al. should be a guiding light for less-experienced surgeons, which would prevent iatrogenic conversion of type III to type IV fractures.4
To conclude, as advised, appropriate referral systems for these fractures should be instituted so that they are managed at specialized centers by well-trained surgeons who manage these fractures frequently.
