Comparision of lateral, medial, and posterior approaches in the surgical treatment of pediatric supracondylar humerus fractures.

Abstract

Objective: The aim of this study was to compare the functional and radiological results of lateral, medial, and posterior surgical approaches in pediatric patients undergoing open reduction and internal fixation for supracondylar humerus fractures.

Methods: A total of 86 patients were included in the study. The clinical and radiographic results of the treatment in patients who underwent open reduction and internal fixation with lateral, medial, and posterior approaches were evaluated. Flynn's criteria were used in the evaluation of cosmetic and clinical results. Comparisons were made between the groups in terms of Baumann angle, lateral capitellohumeral angle, and post-operative complications.

Results: There was no statistically significant difference between the three groups in terms of complications. No statistically significant relationship was observed between Flynn's criteria and surgical approaches. When the relationship among post-operative range of motion (ROM) and surgical approach was evaluated, no extension defect was found in any of the patients, but a significant relationship was found between post-operative flexion ROM and surgical approach (p=0.011).

Conclusion: Closed reduction and percutaneous pinning are preferred in cases of pediatric supracondylar humerus fractures. However, when this method cannot be applied, lateral, medial, and posterior approaches are the possible open reduction methods, that can be safely preferred.