Triceps-sparing Posterior Approach for Supracondylar Fractures in Children

Document Type : RESEARCH PAPER

Authors

1 5th Azar Hospital, Bone, Joint, Connective Tissue Research Center, Gorgan, Iran

2 Shoulder and Elbow Department, IRCCS Humanitas Institute, Rozzano, Milan, Italy

Abstract

Background: The most common pediatric elbow fracture is supracondylar humeral fracture which accounts for 60% of
elbow fractures in children. The aim of this study was to evaluate the results of open reduction and internal fixation of
type III supracondylar humeral fractures using a Triceps sparing posterior approach.
Methods: In total, 98 patients were evaluated from June 2007 to 2014.
Results: According to the results, the mean age of the patients was 6.4 years. The ratios of males to females and the
right to left hand were 2.06 and 2.26, respectively. Totally, 82% of fractures happened in the dominant hand which was
right. The patients underwent surgery within approximately 50.16 hours after injury. Anatomic reduction and internal
fixation were performed under direct vision with no need for image intensifier. The mean time of follow-up was 14.3
months, and all fractures healed clinically and radiologically. Moreover, the maximum lack of an extension was 15° and
the obtained mean was 3.5°. Additionally, the mean final Bauman angle difference with healthy elbow was determined
at 2.4°. The rate of complications was 19.3%, including pin tract infections (7%), pin loosening (3%), heterotopic
ossification (4%), and wound dehiscence (1%). Furthermore, there were 4 cases (4%) of anterior interosseous nerve
palsy, two of which happened before surgery, and the other two following the surgery. All of these complications were
resolved within 3 to 10 weeks spontaneously.
Conclusion: This approach helped preserve the extensor mechanism and ulnar nerve intact to have an acceptable
skin scar esthetically along with satisfactory postoperative function.
Level of evidence: IV

Keywords

Main Subjects

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The Archives of Bone and Joint Surgery
Volume 7, Issue 5
September 2019
Pages 416-421

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History

  • Receive Date: 09 December 2016
  • Revise Date: 20 November 2018
  • Accept Date: 08 December 2018

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