Neurovascular complications and functional outcome in displaced supracondylar fractures of the humerus in children.

Abstract

We retrospectively studied the complications associated with a displaced supracondylar fracture of the humerus in children and its treatment. Between 1978 and 1997, 200 displaced fractures were treated by operative means. In 190 cases closed reduction and percutaneous pinning was performed. In 10 cases vascular impairment or unsatisfactory reduction necessitated open exploration. Functional and cosmetic success was achieved in 90% of all operated children. In 33 (16.5%) of all cases we found neurological impairment. All recovered without sequelae, except for one case with persistent radial nerve palsy which recovered after a sural nerve interposition graft. Transient neurological problems are common in this fracture. A mini-open procedure is recommended for the ulnar Kirschner wire (K-wire) to prevent iatrogenic ulnar nerve injury.