Open Reduction of Paediatric Supracondylar Humerus Fractures has No Negative Impact on Long-term Functional Outcome...

The aim of the study was to compare closed and open reduction of displaced paediatric supracondylar humerus fractures with regard to long-term functional outcome and quality of life.In this retrospective study, 30 patients were examined with a displaced supracondylar humerus fracture (14 boys and 16 girls with a median age of 7 years [5-12 years]). The right elbow was affected in 8 cases (27%) and the left elbow in 22 cases (73%). According to the Gartland/Wilkins classification, there were 3× type IIA (10%), 8 × type IIB (27%), 18 × type III (60%) fractures (missing data n = 1 [3%]). All fractures were fixed with a crossed K-wire osteosynthesis. In the 1st group (n = 12), the fractures were reduced closed. In the 2nd group (n = 18), an open reduction was performed. The Quick Disabilities of the Arm, Shoulder and Hand Score (Quick-DASH) and the Paediatric Quality of Life Score (PedsQL) were recorded as outcome parameters after a mean follow-up of 53 months. The two groups were compared in terms of patient- and treatment-related factors and outcome parameters.The proportion of right elbow fractures was significantly higher in group 1 than in group 2 (50% vs. 11%). In group 2, the proportion of more severely displaced fractures was significantly higher than in group 1 (Gartland/Wilkins type III: 98% vs. 17%) and the median operating time was significantly longer (93 min vs. 26 min). There were no significant differences between the two groups in the Quick-DASH (0 [0-39] vs. 0 [0-11], p = 0.219), in the additional module "Sports and Music" of the Quick-DASH (0 [0-37.5], missing data n = 2, vs. 0 [0-50], p = 0.284) and in the PedsQL (95 [63-100] vs. 96 [86-100], p = 0.328).Open reduction of displaced paediatric supracondylar humerus fractures does not lead to a reduction in long-term functional outcome and quality of life compared to closed reduction.