Sakarya Tıp Dergisi (Sep 2021)
Does The Surgical Approach Have an Impact On Treatment Outcomes and Complications in The Surgical Treatment of Pediatric Supracondylar Humeral Fractures?
Abstract
Objective: In the surgical treatment of supracondylar humerus fractures (SCHF), different treatment methods and surgical incisions are depending on the direction of displacement of the distal fragment and the surgeon’s experience. The aim of this study was to compare SCHF treatment results and complications according to closed reduction percutaneous pinning (CRPP) and the surgical incision type in open surgery and to determine the ideal approach thereby. Material and Methods: A retrospective examination was made of a total of 224 patients for this study which was comprising 142 (63.4%) males and 82 (36.6%) females with a mean age of 5.95±2.79 years (range, 1-13 years). According to the Gartland classification, 58 (25.8%) were Type 2, 166 (74.2%) were Type 3. We divided the patients included in the study into four groups: medial, lateral, posterior incision and those who underwent surgery with CRRP. Results: The most frequent complications observed were neurological deficit (n:34, 15.1%), scarring (n:32, 14.2%), subcutaneous pin migration (n:24, 10.2%), cubitus varus (n:20, 8.9%), pin tract infection (n:15, 6.6%), flexion restriction (n:13, 5.8%), extension restriction (n:12, 5.3%), myositis ossificans (n:12, 5.3%), and cubitus valgus (n:5, 2.29%). There were determined to be differences between the group applied with open reduction internal fixation and the closed reduction percutaneous pinning group in respect of complications. Conclusion: There is no difference between functional results between closed reduction percutaneous pinning and open surgery groups. In patients who cannot be closed reduction, open surgical incisions may be preferred depending on the surgeon's experience and preference.
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