Prospective analysis of a new minimally invasive technique for paediatric Gartland type III supracondylar fracture of the humerus.
OBJECTIVE
The purpose of this study was to introduce a minimally invasive surgery using mosquito forceps for achieving the reduction of severely displaced supracondylar fracture of the humerus in children and evaluate the clinical outcome.


METHODS
Gartland type III supracondylar fractures of the humerus in children under the age of 12 were analysed from January 2000 to January 2007 at our institute. The control group cases were selected by successful reduction using the standard technique described by Rockwood and Wilkins (2001). The others composed the study group. This study included chart reviews, radiographic images of both the antero-posterior and the lateral views, physical examination, and Mayo elbow performance index scores preoperative, postoperative, and final follow-up.


RESULTS
Evaluations were completed for 42 cases. The mean age was 6.9 years and the group consisted of 23 boys and 19 girls. The mean follow-up time was 34.5 months. Twenty-six cases were of injuries to the left side, and 16 were of injuries to the right. The Mayo elbow performance index score was excellent in both groups. Operation time in the control and study groups was 46 and 79min, respectively. There was one case of iatrogenic ulnar nerve injury each in the study and control group. One case of loss of reduction and another with a combination of ulnar nerve injury and loss of reduction were noted in the control group. All four cases had an excellent final outcome. No mosquito-forceps-related complication was found, and in the final follow-up, no cubitus varus was found.


CONCLUSIONS
Minimally invasive surgery with the assistance of mosquito forceps for the reduction of severely displaced supracondylar fracture of the humerus in children was shown to be a safe and effective alternative method. The final functional outcome was the same as that of the standard technique.
Li
Yi-An
YA
Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taiwan.
Lee
Pi-Chang
PC
Chia
Wei-Tso
WT
Lin
Huai-Jen
HJ
Chiu
Fang-Yao
FY
Chen
Tain-Hsiung
TH
Feng
Chi-Kuang
CK
D001864:Bone Wires; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D019299:Decompression, Surgical / Q000379:methods; D004551:Elbow Joint; D005260:Female; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular; D025321:Surgery, Computer-Assisted / Q000379:methods; D013525:Surgical Instruments; D016896:Treatment Outcome; D014459:Ulnar Nerve / Q000293:injuries