OUTCOME OF MEDIAL APPROACH IN TREATMENT OF SUPRACONDYLAR HUMERUS FRACTURES IN CHILDREN

Abstract

The objective of this study was to evaluate the functional outcome of the medial approach for open reduction and internal fixation in pediatric supracondylar humerus fractures, with specific emphasis on elbow range of motion and carrying angle using Flynn’s criteria.

Methodology

This descriptive study was conducted in the Department of Orthopedic Surgery, Nishtar Hospital, Multan, over a period of six months after ethical approval. A total of 79 children aged 2–12 years, presenting with supracondylar humerus fractures of ≤5 days duration, were enrolled using non-probability consecutive sampling. Children with neurovascular compromise or prior treatment by bone setters were excluded. All patients underwent open reduction and internal fixation with crossed Kirschner wires through a medial approach performed by a consultant orthopedic surgeon. Patients were followed for three months postoperatively. Functional outcomes were assessed using Flynn’s criteria. Data were analyzed using SPSS version 23.

Results

The mean age of patients was 6.8 ± 2.9 years, and 65.8% were male. The mean duration from injury to presentation was 2.6 ± 1.3 days. At three months, the mean postoperative elbow range of motion was 128.4° ± 9.6°, and the mean carrying angle was 10.7° ± 3.1°. According to Flynn’s criteria, excellent to good outcomes were achieved in 88.6% of patients for both range of motion and carrying angle. No major postoperative complications were observed.

Conclusion

The medial approach for open reduction and crossed K-wire fixation provides favorable functional and cosmetic outcomes with a low complication rate. It is a safe and effective surgical option for pediatric supracondylar humerus fractures when closed reduction is not feasible.