Outcome of Closed versus Open Reduction in Pediatric Supracondylar Humerus Fractures

Open Access

Abstract

Background: Supracondylar humerus fractures (SHF) are the most frequent type of elbow fractures among pediatric patients, with a high morbidity in case of improper treatment. The study aimed to compare functional and radiological outcomes of closed and open reduction in supracondylar humerus fractures in children. Methods & Materials: This comparative study was conducted at 250 Bedded General Hospital, Manikganj, Bangladesh, from February 2023 to January 2024, including 50 children aged between 2 and 14 years with supracondylar fracture of the humerus (Gartland types II -IV). Clinical and radiological criteria were used to assign patients to either closed reduction using percutaneous K-wire fixation (n=32) or open reduction using internal fixation (n=18). Outcome variables were fracture union, range of motion, carrying angle, and Flynn criteria score. Data were entered and analysed using SPSS version 26 with a p-value of less than 0.05. Results: The most common injury mechanism was a fall while playing, 46.9% in closed vs 38.9% in open reduction. The results of fracture union were 96.9 % in closed and 88.9 % in open reduction. Full or near-full range of motion was restored in 81.2% vs. 50% (p=0.031). The criteria outcomes of Favourable Flynn were obtained in 84.4% of closed and 55.6% of open reduction patients (p=0.041). The aspects of open reduction were strongly connected with the increased hospitalisation (p=0.009) and incidence of neurovascular compromise (p=0.012). Conclusion: Closed reduction with percutaneous K-wire fixation gives better outcomes, positive Flynn scores, and shorter stays. Open reduction is reserved for neurovascular compromise, delayed presentation, or severe displacement.