Open reduction and internal fixation of supracondylar fractures of the humerus: revival of the anterior approach.
BACKGROUND
Supracondylar fractures of the humerus occur commonly in the paediatric age group. Gartland type III fractures are treated by closed manipulation and percutaneous pinning with K-wires. Open reduction is indicated in open fractures, failed closed reductions and in a dysvascular limb. There are various approaches that can be utilized to perform an open reduction. The approach of choice must be safe, surgeon and patient friendly and should provide a good access to the fracture and the important surrounding structures. The anterior approach has been described as the most versatile approach. The aim of the study was to review the advantages and drawbacks of the anterior approach and to assess the functional outcome of fractures treated via this approach.


METHODS
Twenty five (15 male and 10 female) patients out of a hundred and twenty eight children with Gartland type III extension variety of supracondylar fractures of the humerus from underwent open reduction and internal fixation with K-wires via an anterior approach January 2007 to January 2011. The results were assessed at six months using Flynn's radiological and clinical criteria.


RESULTS
Twenty five patients (19.53%) out of hundred and twenty eight patients underwent open reduction and internal fixation. According to Flynn's clinical and radiological criteria, 20 (80%) were found to have excellent and 5 (20%) good results.


CONCLUSIONS
The anterior approach is safe, easy and provides direct exposure of the surrounding neurovascular structures with good to excellent results.
Department of Orthopaedic Surgery, Kathmandu Medical College Teaching Hospital, Sinamangal, Kathmandu, Nepal. rajeevrajmanandhar@gmail.com
R R
RR
Manandhar
S
S
Lakhey
B K
BK
Pandey
R L
RL
Prodhan
S
S
Sharma
K P
KP
Rijal
D002648:Child; D002675:Child, Preschool; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008475:Median Nerve / Q000293:injuries; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome