Related Experiment Video
Updated: Jun 12, 2025
Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
Published on: November 8, 2024
Open Reduction and Fixation of Late-Presenting Pediatric Supracondylar Humeral Fractures: A Prospective Study
1Orthopedic Surgery Department, Gezira Centre of Trauma and Orthopedic Surgery, Wad Madani, Gezira State, Sudan.
Insights
This study shows open reduction and Kirschner wire fixation is effective for neglected pediatric supracondylar humeral fractures (SCHF). The triceps-sparing posterior approach yields satisfactory outcomes in these complex cases.
Area of Science:
- Pediatric Orthopedics
- Trauma Surgery
- Skeletal Repair
Background:
- Supracondylar humeral fracture (SCHF) is a common pediatric injury.
- Delayed presentation of SCHF is prevalent, particularly in developing nations, due to treatment access barriers.
- Lack of standardized treatment protocols and limited literature exist for neglected SCHF.
Purpose of the Study:
- To evaluate the effectiveness and outcomes of open reduction and Kirschner wire fixation.
- To assess a triceps-sparing posterior approach for neglected pediatric SCHF.
- To analyze functional outcomes using established clinical criteria.
Main Methods:
- Prospective multicenter study (July 2016 - June 2021).
- Included 28 pediatric patients with neglected SCHF (≥5 days post-trauma).
- All patients underwent open reduction and K-wire fixation via a posterior triceps-sparing approach, assessed with MEPI and Flynn criteria.
Main Results:
- 100% fracture union achieved within 3-5.5 weeks (mean 4 weeks).
- Excellent/good functional outcomes: 89.3% (MEPI), 96.4% (Flynn criteria).
- Only one patient (3.6%) had an unsatisfactory outcome.
Conclusions:
- Open reduction and Kirschner wire fixation via a posterior triceps-sparing approach are effective for neglected pediatric SCHF.
- This technique provides satisfactory functional results in late-presenting cases.
- The approach is a viable option for complex, delayed pediatric elbow fractures.
Background:
Supracondylar humeral fracture (SCHF) is a common injury in children, and early treatment provides excellent results and prevents disabilities. Delayed presentation is still prevalent, mainly in developing countries, because many factors hinder the opportunity to receive appropriate treatment. Currently, there are no standard treatment protocols, and there is insufficient published literature on this topic. This study aimed to evaluate the effectiveness and outcomes of open reduction and Kirschner wire fixation using a triceps-sparing posterior approach in neglected cases with complicated fractures.
Methods:
This was a prospective multicenter clinical study conducted between July 2016 and June 2021, which included 28 pediatric patients with neglected SCHF who presented to the hospital for definitive treatment five days or more after initial trauma without previous surgical intervention. All the patients underwent open reduction and K-wire fixation using a posterior triceps-sparing approach. The final functional outcome was assessed using the Mayo Elbow Performance Index (MEPI) and Flynn criteria.
Results:
All fractures (100%) united within 3-5.5 weeks (mean 4 ± 0.7 weeks). Excellent scores observed in 67.9% (n = 19), good in 21.4% (n = 6), fair in 7.1% (n=2), and poor in 3.6% (n = 1) patients according to MEPI. Correspondingly, Flynn's criteria showed 96.4% (n = 27) satisfactory and 3.6% (n = 1) unsatisfactory outcome.
Conclusion:
Open reduction and fixation using Kirschner wires through the posterior triceps-sparing approach is an effective treatment method for late-presenting SCHF in children with consequent satisfactory results.
More Related Videos
12:25C-arm-Free Simultaneous OLIF51 and Percutaneous Pedicle Screw Fixation in a Single Lateral Position
Published on: September 16, 2022
07:35Creating Rigidly Stabilized Fractures for Assessing Intramembranous Ossification, Distraction Osteogenesis, or Healing of Critical Sized Defects
Published on: April 11, 2012
