Surgical Approaches in Type III Supracondylar Humerus Fracture in Children: A Comparison between Posterior and Lateral Approaches

Supracondylar humerus Fracture is among the common upper extremity fractures in children. In certain types of fractures of circumstances that open reduction becomes necessary; the best surgical approach is debatable. We would like to report our prospective study between posterior and lateral surgical approaches in type III supracondylar fractures. In a case series study 87 children from birth till 18 years old with type III humerus fracture were randomly selected for open reduction and pinning; 43 through lateral and 44 posterior approaches. With a 6-months follow-up elbow range of motion complications and radiographic parameters related to union type were evaluated. Posterior approach was a faster surgery. Ranges of motion after 1 and after 6 months were more restricted in posterior approach. Baumann and carrying angles were closer to normal in a higher percentage in posterior approach. Varus and valgus malunion or joint stiffness rates or infection were similar in the two groups. The two approaches were similar for postoperative complications. Better range of motion was achieved in the lateral approach and a more anatomical union in the posterior approach.