Abstract
Supracondylar fractures of the humerus are the most common type of elbow fractures in children. The unique anatomy of the elbow and the high potential for complications associated with elbow fractures make their treatment difficult. Although the current trend in the literature is to treat them by closed reduction and per-cutenous pinning, open reduction and cross pinning is an alternative treatment especially in the case of technical insufficiencies.
This retrospective study was performed to understand the clinical results after open reduction and cross pin fixation in 205 children (mean age 7.4 years) with completely displaced supracondylar fractures of the distal humerus between 1994 and 2002. The operation was performed within 5 days after the injury. The posterior skin approach was used but bone was reached through both sides of triceps muscle which was kept intact. The results were assessed according to Flynn’s cosmetic and functional criteria after 48 months of mean follow up.
No patient had neurological or circulatory complication. All the fractures healed and none of them had rotation, recurvation or cubitus valgus deformity. Four children had mild cubitus varus deformity. There were 190 (93%) excellent, 15 (7%) good cosmetic outcome and 170 (83%) excellent, 21 (10%) good, 8 (4%) average, 6 (3%) weak functional outcome.
We still prefer open reduction and cross pinning in the management of unstable supracondylar humeral fractures in children. We find it safer and believe this approach avoids unpleasant complications. Also excellent results can be achieved without being exposed to high doses of radiation.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
