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ORIGINAL ARTICLE
Year : 2017  |  Volume : 20  |  Issue : 9  |  Page : 1106-1111

Comparison of medial and posterior surgical approaches in pediatric supracondylar humerus fractures


1 Department of Orthopedics and Traumatology, Faculty of Medicine, Bülent Ecevit University, Zonguldak, Turkey
2 Department of Orthopedics and Traumatology, Faculty of Medicine, Hitit University, Çorum, Turkey
3 Department of Orthopedics and Traumatology, Faculty of Medicine, Harran University, Şanlıurfa, Turkey

Correspondence Address:
E Sahin
Department of Orthopedics and Traumatology, Faculty of Medicine, Bülent Ecevit University, Zonguldak
Turkey
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/njcp.njcp_104_16

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Objectives: The aim of the current study was to compare the clinical results of pediatric supracondylar humerus fracture cases requiring open reduction through medial approach with posterior approach. Patients and Methods: Retrospective cohort of 67 cases of pediatric supracondylar fractures was reviewed. Thirty-three patients (20 males, 13 female, average age: 8.3 ± 3.131) were treated with medial approach were compared with 34 patients (19 males, 15 females, average age: 7.5 ± 3.146) treated with posterior exposure. Median follow-up period of the first group was 35.04 months (range: 17–76 months) and of the second group was 36.04 (range: 16-65 months). Radiological evaluation included Baumann angle, carrying angles, and lateral humero-capitellar angles. Functional and cosmetic evaluation was assessed with range-of-motion measurements and the criteria defined by Flynn et al. Results: No differences between groups were noted regarding gender, age, and follow-up periods. Operative time was significantly shorter in medial approach group [60.0 ± 14.5 vs. 75.8 ± 17.6 min (P = 0.002)]. Radiological measurements (Baumann, humero-capitellar, and carrying angles) were also similar between groups. When evaluated patients according to Flynn's criteria, for medial group, 31 cases (93.9%) had good–perfect result regarding ROM loss, whereas for posterior group 33 cases (97%) had good–perfect result. Regarding carrying angle change and posterior group were slightly better than medial group (perfect result observed in 91.1% vs 81.8%, respectively). The differences did not show statistical significance. Conclusion: In the treatment of supracondylar humerus fractures in children, both surgical approaches revealed similar functional and radiological outcomes with shorter operative time when medial approach was utilized.


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