Anterior cubital approach for the treatment of T-condylar fractures of the humerus in adolescents and children.

Abstract

A retrospective study compared the anterior cubital approach to the triceps-sparing approach for treating T-condylar humerus fractures in 19 children and adolescents from January 2008 to May 2023. Patients were divided into group A (seven patients, mean age 10.7 years, triceps-sparing) and group B (12 patients, mean age 11.32 years, anterior cubital). Outcomes included surgical duration, incision length, scarring [Vancouver Scar Scale (VSS)], neurovascular complications, and functional results [Mayo Elbow Performance Score (MEPS) and Flynn's criteria]. Group A had a mean incision length of 8.60 cm, surgery duration of 68.29 min, and VSS scores averaging 3.71, with five excellent and two good MEPS results, and five excellent, one good, and one fair Flynn's outcomes. Two patients had radial nerve palsy. Group B showed a shorter mean incision length of 4.63 cm, surgery duration of 51.42 min, and VSS scores averaging 1.33, with 10 excellent and two good results for both MEPS and Flynn's criteria. One patient developed cubitus varus, with one case each of radial and median nerve palsy. Significant differences were found in surgery duration, incision length, and scarring, but functional outcomes were comparable. Multivariable regression, adjusted for confounders, validated significant associations of the anterior cubital approach with reduced surgery duration, shorter incision length, and lower VSS scores, with no significant difference in functional outcomes. The anterior cubital approach is minimally invasive, safe, and effective, offering shorter surgeries, smaller incisions, less scarring, and better neurovascular exploration, with similar functional recovery.