title: Comparison of lateral versus triceps-splitting posterior approach in the surgical treatment of pediatric supracondylar humerus fractures.
abstract: BACKGROUND
  Supracondylar humerus fracture is the most common fracture of the elbow in children. Closed reduction and percutaneous pinning is considered to be the optimal treatment strategy; however, in some instances, open reduction may be necessary. The aim of this retrospective study was to compare clinical and functional results of triceps-splitting posterior versus lateral approach in pediatric supracondylar humerus fracture surgery.
  
  
  METHODS
  A total of 38 patients underwent surgery; Group 1 consisted of 30 patients on whom posterior approach was used, while lateral approach was used on the 8 patients in Group 2. Flynn criteria were used to evaluate cosmetic and clinical results. Fracture healing was assessed with anteroposterior and lateral x-rays. Patients and parents were asked to describe time needed for complete return of full elbow range of motion (ROM) and overall satisfaction.
  
  
  RESULTS
  Mean fracture union time was 44.1 days and 46.3 days, and time required to regain complete or near complete elbow ROM was 57.5 days and 55.7 days after splint removal for Group 1 and Group 2, respectively. Twenty-one of 30 (70%) patients (and parents) in Group 1, and 6 of 8 (75%) patients (and parents) in Group 2 were totally satisfied with the results. Twenty-one of 30 (70%) patients in Group 1, and 6 of 8 (75%) patients in Group 2 had excellent cosmetic and functional results according to Flynn outcome criteria.
  
  
  CONCLUSIONS
  In cases of pediatric supracondylar humerus fracture, early closed reduction and percutaneous pinning is preferred; however, when this method is not applicable, triceps-splitting posterior approach is a safe and comparable method to lateral approach with advantages of easier fracture reduction and shorter operating time.
authors.affiliation: Department of Orthopaedics and Traumatology, Necmettin Erbakan University Meram Faculty of Medicine, Konya-Turkey. turkmenfaik@gmail.com.
authors.forename: Faik
authors.initials: F
authors.lastname: Türkmen
authors.affiliation: Departments of Orthopaedics and Traumatology, and Hand and Upper Extremity Surgery Division, Necmettin Erbakan University Meram Faculty of Medicine, Konya-Turkey.
authors.forename: Serdar
authors.initials: S
authors.lastname: Toker
authors.affiliation: Department of Orthopaedics and Traumatology, Necmettin Erbakan University Meram Faculty of Medicine, Konya-Turkey.
authors.forename: Kayhan
authors.initials: K
authors.lastname: Kesik
authors.affiliation: Department of Orthopaedics and Traumatology, Necmettin Erbakan University Meram Faculty of Medicine, Konya-Turkey.
authors.forename: İsmail Hakkı
authors.initials: İH
authors.lastname: Korucu
authors.affiliation: Department of Orthopaedics and Traumatology, Selçuk University Faculty of Medicine, Konya-Turkey.
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Acar
mesh_terms: D001858:Bone Nails; D002648:Child; D002675:Child, Preschool; D004550:Elbow / Q000601:surgery*; D005260:Female; D005594:Fracture Fixation, Intramedullary; D017102:Fracture Healing; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D061646:Operative Time; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016896:Treatment Outcome; D014421:Turkey