Minimally invasive surgical techniques for irreducible supracondylar fractures of the humerus in children.

BACKGROUND: Treatment of severely displaced supracondylar fracture of the humerus in children remains a challenge. We retrospectively assessed the outcomes of the minimally invasive open reduction techniques used in our institutions for the treatment of grade 3 supracondylar fractures in children which could not be reduced by closed manipulation.

PATIENTS AND METHODS: 78 children (58 boys) with severely displaced supracondylar fractures of the humerus and severe swelling were treated with either a minimal incision in the anticubital fossa and manipulation of the distal fragment with the thumb, or a small stab incision and manipulation of the fracture fragment with a small-sized suction tip. The fractures were stabilized with 1.6-mm Kirschner wires.

RESULTS AND INTERPRETATION: The outcome after a follow-up of at least 3 years was excellent in 76 cases and poor in 2 cases. No scar contractures or other complications were observed. These techniques seem safe and effective in the treatment of irreducible grade 3 supracondylar fractures of the humerus in children.