Vascular compromise following supracondylar fractures is frequently described. Near Infra-red Spectrometry (NIRS) is a technique through which real-time data can be gathered non-invasively on the oxygenation status of tissues. The drive now is to gain knowledge on how NIRS data can be interpreted and to validate its use in the clinical setting. This ethically approved prospective study looks at volar forearm compartment oxygen saturation (StO2) in 20 patients with supracondylar fractures requiring operative intervention. Both the injured limb and the contra-lateral, uninjured limb were monitored. 20 patients from a cohort of 29 had full data sets and are thus presented.Aim
Methods
The aim of the current study was to assess the amount of the distal humerus articular surface exposed through the Newcastle approach, a posterior triceps preserving exposure of the elbow joint. 24 cadaveric elbows (12 pairs) were randomized to receive one of the four posterior surgical approaches: triceps reflecting, triceps splitting, olecranon osteotomy and Newcastle approach. The ratio of the articular surface exposed for each elbow was calculated and compared. The highest ratio observed was for Newcastle approach (0.75 ± 0.12) followed by olecranon osteotomy (0.51 ± 0.1), triceps reflecting (0.37 ± 0.08) and triceps splitting (0.35 ± 0.07). The differences between Newcastle approach and other approaches were statistically significant (p=0.003 vs osteotomy and <
0.0001 vs triceps reflecting and splitting). The Newcastle approach sufficiently exposes the distal humerus for arthroplasty or fracture fixation purposes. Its use is supported by the current study.
