Supracondylar humerus fractures in children. Comparison of operative treatment methods.

A retrospective analysis was performed of 87 children treated operatively for supracondylar humerus fractures by 18 different surgeons during a 6-year period. No patient suffered from compartment syndrome or Volkmann's ischemic contracture. Early postoperative fracture displacement occurred in four (7%) of 60 patients with Type III fractures, and in one (4%) of 23 patients with Type II fractures. Displacement occurred in one (2%) of 52 Type III fractures stabilized with crossed medial and lateral Kirschner wires, whereas displacement occurred in two (28%) of seven Type III fractures stabilized with lateral wires only. Thirty-four patients could be located for long-term followup; complete examination of both upper extremities was performed on these 34 patients at an average of 33 months postoperatively. The long-term results were excellent in 19 (56%), good in seven (21%), fair in one (3%), and poor in seven (21%) patients. Five additional patients were not available for followup at the time of the current study, but had followup of at least 6 months available. Of the 39 patients with followup of at least 6 months, five patients' fractures (13%) healed with coronal plane malalignment greater than 10 degrees which resulted in gunstock deformity. There was no statistically significant relationship between treatment method and gunstock deformity. However, none of the patients with gunstock deformity had compromised activity because of the deformity, and all had full elbow extension and at least 130 degrees elbow flexion.