Waqar Alam, Shams-ur Rehman, Roohullah Jan, Shahid Hussain.
Outcome of open reduction and internal fixation of Supracondylar fractures of humerus in children with lateral approach.
Pak J Surg Jan ;30(2):146-9.

Background: Childhood injuries are the leading cause of death and disability for children over the age of one year. Supracondylar fractures are the most common type of elbow fractures. Open reduction and internal fi xation of these fractures is an eff ective and safe method of primary treatment and is associated with good outcomes. Th e aim of the study was to evaluate the advantages and drawbacks of the lateral approach and to assess the functional outcome of fractures treated via this approach. Methods: Th e study was conducted at Orthopedics and trauma unit, District Headquarter Hospital Timergara Dir Lower. Th ere were 179 patients with closed supracondylar fractures of the humerus in children under 12 years of both genders. All patients were operated under general anaesthesia with lateral approach for open reduction and tinternal fi xation. Patients were discharged at second postoperative day. Th e patients were seen at 2, 4, 6, 12 and 24 weeks. At 4 weeks, K-wires were removed. A radiograph of both the elbows was taken on fi nal visit. Patients were assessed clinically and radiologically for carrying angle and range of motion of elbow. Th e results were evaluated aft er 6 months according to Lagrange-Rigault’s range of motion scale. Results: A total of 153 patients were included in the study. 97(63.4%) were males while 56(36.6%) were girls. Mean age was 7.5 years ranging from 4 to 12 years. Left side was involved in 89(58.2%) of cases while right side was involved in 64(41.8%). Th e main etiological cause for fracture was fall. Out of 153 patients we lost 11(7%) patients in our follow up. On analysis of our results 116 (81.7%) had excellent results, 17 (12%) patients had good results and 9 (6.33%) patients had poor results while none had bad results according to LagrangeRigault’s range of motion scale. Conclusion: ORIF lateral approach is the technique of choice although exposure with this approach is a bit diffi cult but its easy to perform and less time consuming. Th e fi nal outcome is bett er, so we recommend this approach while doing ORIF.

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