Medial Approach for Open Cross-Pinning of Paediatric Displaced Supracondylar Elbow Fractures

Objective: To describe the medial approach for open cross-pinning of paediatric displaced supracondylar elbow fractures and to assess the morbidity and its clinico-radiological outcome. Methods: A total of 36 Children operated via medial approach for closed displaced supracondylar elbow fractures (Gartland extension type III) without associated neurovascular complications were selected for assessment of radiological (Baumann's angle difference and bony union) and clinical (elbow motion and loss of carrying angle) outcome. The final Results were evaluated at six monthsA¢â‚¬â„¢ time using Flynn's criteria. Results: Out of the 36 analyzed Children, 10(27.7%) were female and 26 (72.3%) were male. 22 (61.2%) had left elbow while 14 (38.8%) had right elbow involvement. The Mean age at the time of fracture was 6 years (range, 2 - 11 years). Mean time from fracture to surgery was 6.8 days (range, 0 A¢â‚¬â€œ 15 days). We had no instance of postoperative deep infection, neurovascular complications and myositis ossificans. All the fractures healed within the expected time. Full range of elbow motion was achieved in 91.6% patients within 6-8 weeks of pin removal. According to the FlynnA¢â‚¬â„¢s criteria, satisfactory results were obtained in all patients.Conclusions: The medial approach for open cross-pinning of paediatric displaced supracondylar elbow fractures in our view is a logical, safe and elegant approach with predictable good clinico- radiological results. This approach not only provided an excellent view of the medial column but also avoid iatrogenic ulnar nerve palsy. Key words: Medial approach, displaced, Paediatric, Supracondylar elbow fracture, cross-pinning.