K-wire fixation of supracondylar humeral fractures in children: results of open reduction via a ventral approach in comparison with closed treatment.

The morbidity and functional outcome of K-wire fixation of dislocated supracondylar humeral fractures in children after open reduction through a ventral approach were studied, using the results after closed reduction as a golden standard. A series of 49 children were evaluated retrospectively. Of these, 46 children could be included in the study, of whom 35 were treated with closed reduction (group A) and 11 were treated with open reduction via a ventral approach (group B). All fractures were splinted in plaster for 3 weeks postoperatively. Thereafter free active motion of the elbow was permitted. Our data show that open reduction via a ventral approach carries no morbidity. The time for full functional recovery was equal in both groups. Only one out of 11 patients showed mild varus deformity after open reduction, while this slight malalignment occurred in five of 35 patients after closed reduction. The final anatomical and functional results did not differ between the two groups. It can be concluded that K-wire fixation of dislocated supracondylar fractures in children gives excellent results and that open reduction via a ventral approach is a logical, safe and elegant alternative, if closed reduction fails.