Operative fixation of severely displaced supracondylar fractures of the humerus in children

ABSTRACT

This study was conducted on 29 severely displaced unstable supracondylar fractures of the humerus in Nizwa Hospital from June 1992 to March 1997. These fractures were treated by open reduction and internal fixation by a bicipital approach to the elbow joint using criss-cross K-wires. The advantages of opening the elbow from both sides provide for an exact anatomic reduction of the fracture which can be appreciated by the naked eye from the antero-posterior, medial and lateral sides; by using criss-cross K-wires the chances for medial or lateral angulation of the distal fragment are minimized and this thus prevents cubitus varus or cubitus valgus; and lastly, it obviates the need for an image intensifier where it is not available. In this series all the patients, except one, finally had excellent results with full range of movements of the elbow joint with no cubitus varus or valgus deformity. The one patient who developed late cubitus varus had also loss of terminal 15° of flexion