Short-Term Clinical and Radiological Outcomes of Triceps-Sparing Posterior Approach in Displaced Pediatric Supracondylar Humeral Fractures

Open Access

Abstract

Background: Fractures of the supracondylar region of the humerus are the most frequent elbow injuries in children, making up around 60% of all pediatric elbow fractures. This study aimed to assess the short-term clinical and radiological outcomes of using a triceps-sparing posterior approach in children with displaced supracondylar humeral fractures. Methods & Materials: This prospective observational study was conducted at the National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Sher-E-Bangla Nagar, Dhaka, from July 2020 to June 2022, including 44 children aged 5-10 years with displaced supracondylar humeral fractures, all treated using the triceps-sparing posterior approach. Surgery was performed within 4-7 days after injury, and patients were monitored over a short follow-up period. Radiological evaluation was carried out using Baumann’s angle and the carrying angle. Clinical assessment included healing duration, elbow range of motion, triceps muscle strength (based on MRC grading), and functional outcomes measured using Flynn’s criteria. Data were entered and analyzed using SPSS version 26. Results: The mean age of participants was 7.41 ± 1.66 years, with a higher proportion of boys (75%). The most common cause of injury was falling from a tree (54.5%), and the left arm was more frequently affected (72.7%). Baumann’s angle remained stable from the postoperative period (76.77 ± 2.04°) to the final follow-up (76.84 ± 2.46°). The average healing time was 5.00 ± 1.01 weeks. The mean elbow range of motion was 129.30 ± 3.45°. Normal triceps strength (5/5 MRC) was maintained in 90.9% of patients. Complications were observed in 13.6% of cases. Based on Flynn’s criteria, 75% of patients had excellent outcomes, while 13.6% had good outcomes. Conclusion: The triceps-sparing posterior approach provides favorable short-term clinical and radiological results in children with displaced supracondylar humeral fractures. It effectively preserves triceps strength and achieves a high rate of excellent functional outcomes, supporting its use as a reliable surgical technique.