Delayed open reduction for supracondylar fractures of the humerus.

Twenty children with grade IV supracondylar fractures of the humerus had an open reduction 11 to 17 days after injury. The delay was due to swelling and blisters. Most patients recovered a useful range of movement and there were no complications. A posterior approach with V-Y plasty of the triceps makes it easy to align the fragments and reduces the incidence of cubitus varus. Apprehension about the risk of increasing the extent of myositis ossificans is unfounded.