Triceps-sparing Posterior Approach for Supracondylar Humeral Fracture in Children
Related Experiment Video
Updated: Jan 3, 2026
Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Saeed Kokly1,2,3, Alessandro Castagna1,2,3, Mehdi Aarabi1,2,3
15 Azar Hospital, Bone, Joint, Connective Tissue Research Center, Gorgan, Iran.
Insights
This study evaluated a triceps sparing posterior approach for pediatric type III supracondylar humeral fractures. The technique achieved good outcomes with preserved function and acceptable scars, despite a 19.3% complication rate.
Area of Science:
- Pediatric Orthopedics
- Traumatology
- Surgical Techniques
Background:
- Supracondylar humeral fractures are the most common pediatric elbow fractures, accounting for 60% of cases.
- Type III fractures often require surgical intervention.
Purpose of the Study:
- To evaluate the outcomes of open reduction and internal fixation for type III supracondylar humeral fractures using a triceps sparing posterior approach.
Main Methods:
- A retrospective study of 98 pediatric patients with type III supracondylar humeral fractures treated between June 2007 and 2014.
- Surgery involved open reduction and internal fixation via a triceps sparing posterior approach, performed under direct vision.
Main Results:
- The mean patient age was 6.4 years, with 82% of fractures occurring in the dominant right hand.
- All 98 fractures healed clinically and radiologically with a mean follow-up of 14.3 months.
- Complications occurred in 19.3% of patients, including pin tract infections, loosening, heterotopic ossification, wound dehiscence, and transient anterior interosseous nerve palsy.
Conclusions:
- The triceps sparing posterior approach is effective for treating pediatric type III supracondylar humeral fractures.
- This technique preserves the extensor mechanism and ulnar nerve, leading to satisfactory functional outcomes and esthetic results.
- While complications are possible, most are minor and resolve spontaneously.
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.
More Related Videos
07:22Arthroscopic Management of Massive Irreparable Rotator Cuff Tears: Whole Rotator Cable Reconstruction Using Proximal Biceps Tendon Autograft
Published on: June 6, 2025
08:11Vascularized Composite Upper Limb Allograft Harvesting for Proximal Arm Allotransplantation
Published on: June 13, 2025
Related Concept Videos
01:19Bones of the Upper Limb: Humerus
01:31Muscles that Move the Arm
The pectoralis major has two origins. Its clavicular head originates on the medial half of the clavicle. In contrast, the sternocostal head originates on the costal cartilages of ribs 1-6, the sternum, and the aponeurosis of the external oblique of the...
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...