Open reduction and internal fixation of pediatric humeral supracondylar fractures. Ten-year follow-up

Abstract

ObjectiveThe aim of this study was to evaluate the long-term results of the surgical treatment by means of open reduction and internal fixation of displaced supracondylar humerus fractures in a paediatric population. Patients and methodsDescriptive retrospective study conducted between 1996 and 2003, which included 21 patients who underwent open reduction and internal fixation for the treatment of displaced, supracondylar humerus fractures according to the Gartland classification, which were irreducible by closed methods. The patients were clinically evaluated according to the Flynn criteria (functional and cosmetic). Data collection also included postoperative radiological evaluation, range of movement, the presence of post-operative complications, and a questionnaire on satisfaction with treatment received. The mean age of the patients was 5.8 years. Mean follow-up was 11.52 years. ResultsThe average post-operative Baumann angle was 17.6°. Final loss of flexion averaged 5.1° (range: 0–20°), and loss of extension 0.71° (range: 0–10°), with 90% of patients demonstrating an elbow range of movement within normal limits. According to the Flynn criteria, functional and cosmetic results were satisfactory in 85.5%. Superficial wound infection and metal work migration were the most common post-operative complications. At the final follow-up all patients, except two, were very happy with the result, and no patient complained of difficulties in carrying out normal living activities or their favourite sports. ConclusionsIn cases of unsatisfactory reduction or failure to maintain a stable closed reduction, open reduction and internal fixation demonstrate equivalent results to closed procedures.