Open reduction and internal fixation for supracondylar humerus fractures in children

Eight hundred sixty-two supracondylar humerus fractures were treated betwee n January 1984 and July 1997. Sixty-five (8%) patients were managed with op en reduction and internal fixation with pins. The remaining 797 patients (9 2%) were managed with either casting, closed reduction with or without perc utaneous pinning, or traction. Of the 65 patients managed with open reducti on, 46 (71%) of those fractures were irreducible, 16 (24%) had associated v ascular compromise, eight (12%) were open, and one was associated with a po streduction nerve palsy and nonanatomic reduction. According to the criteri a of Flynn et al. 18 (55%) elbows were rated excellent, eight (24%) were ra ted good, three (9%) were rated fair, and four (12%) were rated poor after an average of 5.8 months postinjury. This study indicates that highly satis factory results can be Obtained in severely displaced fractures managed wit h open reduction in these situations.