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Comparative Evaluation of Two Fluoroscopic Techniques in Pediatric Supracondylar Humerus Fractures: A Retrospective
Ali Can Çiçek1, Mehmet Fatih Aksay1, Ümit Aygün1
1Department of Orthopedics and Traumatology, Ağrı İbrahim Çecen University, Ağrı, Turkey.
Insights
A modified fluoroscopic technique for pediatric supracondylar humerus fractures significantly reduces operative time, preparation time, and fluoroscopy exposure compared to the conventional method, with similar outcomes.
Area of Science:
- Pediatric Orthopedics
- Surgical Techniques
- Radiology
Background:
- Supracondylar humerus fractures are common in children.
- Closed reduction and percutaneous pinning are standard treatments for displaced fractures.
- Intraoperative fluoroscopy is crucial, impacting surgical efficiency and radiation exposure.
Purpose of the Study:
- To compare a modified fluoroscopic approach with the conventional method for pediatric Gartland type II supracondylar humerus fractures.
- To evaluate the impact of surgical setup on operative time, radiation exposure, and workflow efficiency.
Main Methods:
- Retrospective, non-randomized comparative study of 91 children (aged 1-13) with Gartland type II fractures.
- Two groups: conventional method (CM, n=49) and modified method (MM, n=42).
- Comparison of demographic data, operative duration, fluoroscopy exposure, preparation time, radiological alignment, pin removal, complications, and Mayo Elbow Performance Scores.
Main Results:
- No significant differences in age, sex, or radiographic alignment between groups.
- The modified method group showed significantly shorter operative time, preparation time, and fluoroscopy duration.
- No infections or neurovascular complications were reported in either group.
Conclusions:
- The modified fluoroscopic technique is a safe and efficient alternative for pediatric supracondylar humerus fractures.
- It offers reduced operative and fluoroscopy times without compromising clinical or radiological outcomes.
Abstract:
BACKGROUND Supracondylar humerus fractures are the most common elbow fractures in children and are frequently treated with closed reduction and percutaneous pinning when displaced. Because this procedure relies heavily on intraoperative fluoroscopy, surgical setup can influence operative time, radiation exposure, and workflow efficiency. However, comparative evidence on different fluoroscopic positioning strategies and antisepsis protocols remains limited. This retrospective, non-randomized study was designed to compare a conventional technique with a modified fluoroscopic approach in pediatric Gartland type II supracondylar humerus fractures. MATERIAL AND METHODS This retrospective, non-randomized comparative study included 91 children aged 1 to 13 years with Gartland type II supracondylar humerus fractures treated between 2019 and 2023. Patients were divided into 2 groups according to the surgical method: conventional method (CM, n=49) and modified method (MM, n=42). Demographic data, operative duration, fluoroscopy exposure, preparation time, radiological alignment, pin removal timing, complications, and Mayo Elbow Performance Scores were compared. RESULTS There were no significant differences in age, sex distribution, or radiographic alignment between the groups. The MM group had significantly shorter operative time, preparation time, and fluoroscopy duration. No infections or neurovascular complications were observed. Functional outcomes and fracture union were similar in both groups. CONCLUSIONS The modified technique appears to be a safe and efficient alternative to the conventional method, providing shorter operative and fluoroscopy times while maintaining comparable early clinical and radiological outcomes.
