Comparison of outcome with medial versus lateral approach for operative fixation of superacondylar humeral fractures in paediatric patients.

Abstract

Objectives: To compare the outcome in terms of carrying angle with medial versus lateral approach in the treatment of these fractures among children. Study Design: Randomized Clinical trial. Setting: Department of Orthopaedic Surgery Civil Hospital Bahawalpur and Nishtar Hospital Multan. Period: From June 2018 to September 2019. Material & Methods: A total of 154 children of both genders, aged 2-14 years having supracondylar humeral fracture of type II and III, with duration of fracture within 7 days, were enrolled. Patients were divided in two groups (77 in each group), group A and group B. Group A was managed by open reduction internal fixation (ORIF) with cross K-wire through medial approach and group B underwent lateral approach. Results: Out of 154 cases, 102 (66.2%) were boys and 52 (33.8%) were girls. Overall, mean age was noted to be 7.98 ± 2.23 years. Obesity was present in 16 (10.4%) cases. Mean duration of fracture was noted to be 4.21 ± 1.34 days while 106 (68.8%) had duration less than 5 days. There were 119 (77.3%) cases with history of fall and 35 (22.7%) had history of road traffic accidents (RTA). Sixty one (39.6 %) cases were classified as Gartland type II fractures while remaining 93 (60.4 %) were type III fractures. Excellent outcome with carrying angle 0–5^o in group A was noted to be 67 (87 %) while that of group B was 54 (70.1%) (p = 0.011). Conclusion: Medial approach for the treatment of pediatric SHF was noted to be superior in terms of postoperative carrying angle having satisfactory outcome in comparison with the lateral approach.