Open reduction of displaced pediatric supracondylar humeral fractures through the anterior cubital approach.

The authors performed a retrospective review of the anterior cubital approach, an alternative exposure for displaced pediatric supracondylar fractures. Anatomic structures that hinder reduction, such as the brachialis muscle or joint capsule, and neurovascular tissues can be identified easily with this approach. Sixty-one children with displaced supracondylar humeral fractures were treated surgically with Kirschner wires using the anterior cubital approach between January 1996 and August 2002. The cohort comprised 35 boys and 26 girls with a mean age of 8.7 years (range 3-13 years). Mean follow-up was 3.5 years (range 1-6 years). Preoperatively 13 children (21.3%) had a neurovascular insufficiency that required an exploration during the operation. All patients were reduced completely with full anatomic position. On follow-up, no patient had any scar formation or deformity or experienced any restricted motion. The authors conclude that the anterior cubital approach is very effective and is an option for the treatment of pediatric supracondylar humerus fractures without serious complications.