Surgical management of the severely displaced supracondylar fracture of the humerus in children.

We reviewed 44 children with a widely displaced supracondylar fracture of the humerus (Gartland grade III) treated with primary open reduction and cross pinning. The average age was 8 years and the mean delay in presentation was 34 h. Comminution of the medial supracondylar pillar was seen in 57% of the cases. After treatment, the range of the elbow motion was restricted in eight patients. Cubitus varus was not seen. There was no deep infection or myositis ossificans. Post-operatively, five children had a temporary nerve palsy. According to Flynns' criteria, 42 patients had a satisfactory outcome.