Therapeutic Results of Supracondylar Fractures of Children's Arms Using Lateral and Posterior Approach

Background and purpose: Supracondylar fracture of the humerus is common in children and various surgical procedures are used to manage this condition. This study was conducted to compare the treatment results of open surgical approaches; external (lateral) and posterior access. Materials and methods: This cross-sectional study was performed in 200 children (younger than 10 years of age) with supracondylar fractures of the arm attending Babol Shahid Beheshti Hospital (2014-2018) who underwent open surgery using either lateral or posterior approach. Radiographic examination and some factors such as age, sex, cause of fracture, type of fracture, fracture side, and range of motion of elbow joint were compared between the two groups at week eight after the surgeries. Results: Among the patients, 98 (48.8%) underwent surgery with lateral approach and 102 (51.2%) underwent posterior approach. There were no significant differences between the two groups in age, sex, fracture side, and the predominance of the involved arm (P<0.05). We observed no significant differences between the range of motion, bearing angle, flexion and extension of the injured side. Clinical and radiological variables in injured and healthy hands in the external approach showed that range of motion (152.45±3.27 vs. 143.61±4.50), carrying angle (11.98±1.72 vs. 11.44±2.75), and flexion (141.91±3.30 vs. 134.35±4.85) and extension (10.60±1.69 vs. 9±2.35) of the elbow were lower in the injured hand (P<0.001). In comparing the clinical and radiological variables between the injured and healthy hand in the posterior approach, it was found that the range of motion (152.78±3.64 vs. 144.39±4.39), carrying angle (12.4±1.47 vs. 11.62±1.83), and flexion (142.54±3.33 vs. 135.41±4.36) and extension (10.14±1.81 vs.  8.89±2.07) of the elbow were lower in the injured hand (P<0.001). Conclusion: The study showed no significant differences between external and posterior approaches in treatment of supracondylar fractures of the arm.