Distance of translation as a predictor of failure of fixation in paediatric supracondylar fractures.

Introduction This study investigates the influence of incomplete reduction of supracondylar fractures on the incidence of loss of reduction requiring reoperation Materials and methods A review of 107 consecutive patients presenting with supracondylar fractures treated with closed reduction and Kirschner wire stabilisation, between January 2011 and March 2013, was conducted. The mean age was 5 years (range 10 months to 12 years). Pre-, intra- and postoperative radiographs were reviewed. All patients who had failure of fixation requiring revision surgery were identified. Results Ninety-nine patients had an initial adequate radiographic reduction. Of these, one (1%) required revision surgery. Eight patients had an initial incomplete radiographic reduction and, of these, six (75%) required revision surgery (P < 0.0001). Discussion Supracondylar fractures treated with closed reduction and K wire stabilisation require adequate intraoperative reduction. Incomplete reduction should not be accepted, as despite the bones potential to remodel, the risk of further loss of reduction is high, requiring reoperation.