Surgical Outcomes of Pediatric Humeral Supracondylar Fractures Treated By Posterior Approach and Triceps Splitting

Objective: The aim of this study is compare the outcomes among three different approaches (lateral approach, medial approach and posterior approach) for supracondylar humerus fractures in children. Study Design: Retrospective cohort study Place and Duration: The study was conducted at Orthopedics department of Ayub Teaching Hospital, Abbottabad for duration of one year from January 2020 to December 2020. Methods: There were one hundred and thirty five children had supracondylar humerus fracture were presented. Patients were aged between 3-12 years. Informed written consent was taken from authorities for detailed demographics age, sex, cause of fracture and side of fracture. Patients were categorized into three equal groups, group A had 45 patients and received lateral approach, group B had 45 patients and received medial approach and group C received posterior approach with 45 cases. Shaft Condylar Angle (SCA) and Baumann angle were used to analyze the radiological result. All children were assessed using Flynn's criteria for functional outcomes, and the results were divided into Excellent, Good, Fair and Poor. Post-operative outcomes among all the three groups were calculated and compared. SPSS 23.0 version was used to analyze complete data. Results: There were 90 (66.7%) males (30 in each group and 45 (33.3%) females (15 in each group). In group A mean age was 6.88±5.45 years, mean age in group B was 7.11±5.33 years and in group C mean age was 7.17±5.66 years. Sports 85 (62.9%) was the most common cause of fracture followed by traffic accidents 30 (22.2%) and the rest were 20 (14.8%) fall from the height. According to radiological outcomes, Mean shaft condylar Angle in group A was 41.5±6.3, in group B was 41.8±1.9 and in group C was 40.1±3.8 respectively (P>0.05). Mean Bauman angle in group A was 18.8±6.11, group B was 19.4±7.5 and in group C 20.4±5.3 with (P>0.05). According to Flynn’s criteria, excellent outcomes were observed in 33 (73.3%) in LA group, 24 (53.3%) in MA group and 22 (48.9%) in PA group, good results were observed in 11(24.4%), 19 (42.2%) and 21 (46.7%), fair outcomes in 1 (2.2%), 2 (4.4%) and 2 (4.4%). Conclusion: As a result of this research, we have concluded that the lateral technique for supracondylar fractures is superior to the medial or posterior approaches in terms of radiological and functional results. However, there was no statistically significant difference between the three groups. Keywords: Supracondylar fractures, Flynn’s criteria, Functional outcome, Open reduction

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Modified supracondylar dome osteotomy: our experience in 11 children

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20172504 ◽

2017 ◽

Vol 3 (4) ◽

pp. 766

Author(s):

Abhinav . ◽

Ajoy Kumar Manav ◽

Arjun Singh

Keyword(s):

Posterior Approach ◽

Plate Fixation ◽

Excellent Result ◽

Older Children ◽

Supracondylar Fractures ◽

Loss Of Correction ◽

Dome Osteotomy ◽

K Wires ◽

The Stability ◽

Supracondylar Dome Osteotomy

Background: The present retrospective study was done with 11 children having cubitus varus following supracondylar fractures to access the stability of modified domeosteotomy and its fixation with k-wires in older children.Methods: 11 children, 7 males & 4 females were included in the study. The osteotomy was performed through posterior approach. The triangular wedge rotated inside the notch was inherently stable and also fixed with k-wires. Patients were followed at regular intervals. K wires were removed at 6 weeks and the physiotherapy started.Results: The correction obtained under vision was well maintained post operatively in 10 out of 11 cases. In only one case there was back out of k-wires and loss of correction. 5 cases had excellent result followed by 4 good and one fair result. Conclusions: Modified dome osteotomy performed through posterior approach and fixed with k-wires gives good results. Removal of the k-wires is simple. However, in children above 14 years plate fixation might be better to prevent loss of correction.

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Supracondylar fractures of the humerus in childhood: range of movement following the posterior approach to open reduction

Injury ◽

10.1016/0020-1383(91)90128-2 ◽

1991 ◽

Vol 22 (6) ◽

pp. 456-458 ◽

Cited By ~ 36

Author(s):

T.F. Sibly ◽

P.J. Briggs ◽

M.J. Gibson

Keyword(s):

Open Reduction ◽

Posterior Approach ◽

Supracondylar Fractures ◽

Range Of Movement

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Surgical outcomes of the anterior versus posterior approach for advancement of the levator aponeurosis in Japanese patients

Journal of Plastic Reconstructive & Aesthetic Surgery ◽

10.1016/j.bjps.2020.08.051 ◽

2020 ◽

Vol 73 (11) ◽

pp. 2001-2009

Author(s):

Hiromichi Matsuda ◽

Tsutomu Sakai ◽

Yasuhiro Takahashi ◽

Tadashi Nakano

Keyword(s):

Surgical Outcomes ◽

Posterior Approach ◽

Japanese Patients ◽

Levator Aponeurosis

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SUPRACONDYLAR HUMERUS FRACTURES;

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.04.3347 ◽

2019 ◽

Vol 26 (04) ◽

Author(s):

Fayyaz Ahmad Orfi ◽

Asrar Ahmad ◽

Irum Saleem ◽

Maheen Orfi

Keyword(s):

Functional Outcome ◽

Posterior Approach ◽

Operative Time ◽

Lateral Approach ◽

P Value ◽

Supracondylar Fractures ◽

Group A ◽

The Mean ◽

Group B ◽

Approach Group

Objectives: To compare lateral versus posterior approach in the management of supracondylar fractures of humerus in children in terms of functional outcome. Study Design: Retrospective Comparative study. Place and Duration of Study: This retrospective study was carried out over a period of seven years from Oct 2009 to Oct 2016, at Combined Military Hospitals Kharian, Malir and Nowshera. Patients and Methods: All the children having supracondylar fracture (Gartland Type-II and III) who underwent surgical intervention either by posterior or lateral approach were included in the study. In Group-A children operated by posterior approach were placed while in Group-B children were operated by posterior approach. They were followed up in OPD after 6 months. The final functional and cosmetic outcome was assessed by using Flynn’s criteria. Data was analysed by using SPSS version -20. A p-value of less than 0.05 was considered as statistically significant. Results: A total of 104 cases were operated during this study period. Fifty-four cases were done by posterior approach (Group-A), while 50 cases were operated by lateral approach (Group-B). In Group-A the mean age was 6.1 years while in Group-B, mean age was 6.6 years. In Group-A the male to female ratio was 72:28 while in Group-B it was 64:36. The mean weight in Group-A was 19.81Kgs (SD: ±4.53) while in Group-B it was 20.44 Kgs (SD:± 3.97). The mean operative time in Group-A was 36.30 minutes (SD: ±3.32) and in Group-B it was 23.58 minutes (SD: ±2.12). The functional outcome at six months follow-up was excellent in 35 (65%), good in 8 (15%), fair in 7 (13%) and poor in 4(7%) cases in Group-A while in Group-B it was excellent in 35 (70%), good in 10 (20%), fair in 4 (8%) and poor in only one case (2%). This difference was not significant at a p-value of 0.441. Conclusion: Though lateral approach required less operative time but there was no statistically significant difference from the posterior approach comparing the functional outcome in the management of paediatric supracondylar fractures of humerus.

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