Omidi-Kashani F, Hasankhani EG and Hasankhani GG
Background: A significant number of complications that maybe occur with surgical treatment of humeral supracondylar fractures in children are approach related. In this study we tried to compare the outcome of triceps splitting (posterior approach) with other approaches.
Methods: Thirty six consecutive children with displaced Gartland Type III extension supracondylar fractures underwent open reduction and internal fixation in our university hospital from March 2005 to March 2011. They were divided into three groups on the basis of surgical approach; Group A (14 patients) posterior approach with triceps splitting, Group B (10patients) posterior approach with tongue shape flap, and Group C (12 patients) lateral, anterolateral, or medial approach.
Results: In group A, range of motion was graded as excellent in 71.43%, good 21.43%, and fair 7.14%. In group B, the range of motion was excellent in 70%, good 20%, and fair 10%. Deformity was observed in one patient (10%). In group C the range of motion of the elbow was excellent in 66.6%, good 16.7%, and fair 16.7%. Deformity was seen in two (16.7%) patients. Pin tract infection was seen in one patient in each group.
Conclusion: In surgical treatment of humeral supracondylar fracture with normal neurovascular state in children, due to its simplicity, greater exposure, lack of interference with vital structures, and better surgical outcome, the posterior approach particularly posterior triceps splitting method is advocated.
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