Posterior versus lateral surgical approach in reduction of humerus supracondylar fracture in children: a prospective study to compare related complications.

Abstract

Background: Severely displaced fractures demand great effort and a challenge.

Objective: To compares between postoperative complications related to posterior and lateral surgical approaches in reduction of humerus supracondylar fracture in children.

Patients and Methods: A prospective study conducted at four public and private hospitals in Erbil city between 1st October 2008 and 30th June, 2009. A total of 35 child with a mean age of 7.8 year, suffering from extension supracondylar fracture of humerus (type II or III) were enrolled in the study and followed up for five months. Regardless of type of fracture, 21 cases were treated by posterior surgical approach and 14 cases by lateral surgical approach.

Results: Of the patients treated by posterior approach, one patient (2.9%) developed infection at the site of the pin in the early post-operative period, and seven (20%) developed stiffness 10-20° of elbow with either loss of extension or of flexion. While those treated by lateral approach, only two patients (5.7%) developed cubitus varus      5-10°. Overall, significant difference (P = 0.022) between related complications of the two surgical approaches are observed, were lateral approach shows a lower related complication than posterior approach (14.3% and 38.1% respectively).

Conclusion: Surgical treatment of extension supracondylar fracture of humerus (type II or III) by lateral pinning approach has less related complications than posterior approach.