title: Compared outcomes after percutaneous pinning versus open reduction in paediatric supracondylar elbow fractures.
abstract: BACKGROUND
  Supracondylar fractures of the elbow are common in children. Their treatment is controversial when displacement has occurred, although percutaneous pinning is usually advocated.
  
  
  OBJECTIVE
  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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
  
  
  METHODS
  Level IV, retrospective study.
authors.affiliation: Department of Pediatric Surgery, Yopougon Teaching Hospital Center, 21 BP 632, Abidjan 21, Côte d'Ivoire.
authors.forename: J B
authors.initials: JB
authors.lastname: Yaokreh
authors.forename: P
authors.initials: P
authors.lastname: Gicquel
authors.forename: L
authors.initials: L
authors.lastname: Schneider
authors.forename: C
authors.initials: C
authors.lastname: Stanchina
authors.forename: C
authors.initials: C
authors.lastname: Karger
authors.forename: E
authors.initials: E
authors.lastname: Saliba
authors.forename: O
authors.initials: O
authors.lastname: Ossenou
authors.forename: J-M
authors.initials: JM
authors.lastname: Clavert
mesh_terms: D000293:Adolescent; D001858:Bone Nails; D001864:Bone Wires; D002648:Child; D002675:Child, Preschool; D004551:Elbow Joint / Q000601:surgery; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D000092464:Elbow Injuries