Background: Supracondylar fractures of the elbow are common in children. Their treatment is controversial when displacement has occurred, although percutaneous pinning is usually advocated. Hypothesis: In paediatric extension-type supracondylar fractures of the elbow, percutaneous pinning and crossed K-wire fixation after open reduction via the medial approach produce similar functional outcomes and complication rates. Materials and methods: We retrospectively reviewed the medical charts of 58 children aged 2 to 15 years who underwent surgery for extension-type supracondylar elbow fractures between 2004 and 2008. Closed reduction and percutaneous pinning was used in 33 patients with a mean age of 7 years and 11 months; open reduction with cross-wiring in 25 patients with a mean age of 7 years. Functional outcomes were assessed using Flynn's criteria. Baumann's angle was determined and postoperative complications and sequelae were recorded. Results: Outcomes were satisfactory in 30 (90.9%) patients treated with percutaneous pinning and in 23 (92%) patients treated with open reduction and cross-wiring. Mean Baumann's angle at last follow-up was 73.9 ± 5.74° after percutaneous pinning and 74.76 ± 4.07° after open reduction and cross-wiring. Postoperative complications consisted of reoperation in six (10.3%) patients and iatrogenic nerve injury in two (3.4%) patients. Cubitus varus occurred in two (6.06%) patients after closed treatment and in one (4%) patient after open treatment. In each group, three (5.1%) patients had greater than 15° of motion range limitation. Discussion: In children with extension-type supracondylar elbow fractures, outcomes are similar with percutaneous pinning and with open reduction via the medial approach followed by cross-wiring. Level of evidence: Level IV, retrospective study. © 2012.
Yaokreh, J. B., Gicquel, P., Schneider, L., Stanchina, C., Karger, C., Saliba, E., … Clavert, J. M. (2012). Compared outcomes after percutaneous pinning versus open reduction in paediatric supracondylar elbow fractures. Orthopaedics and Traumatology: Surgery and Research, 98(6), 645–651. https://doi.org/10.1016/j.otsr.2012.03.021