Management of supracondylar humerus fracture with cross k wires by triceps sparing approach

Supracondylar fracture accounts for 60% of all fractures about elbow in children and represent 3% of all fractures in children. The rate of supra condylar fractures steadily increases with age and reaches peak by 57 years. It is a fracture involving thin portion through coronoid, olecranon fossa or above the fossa or metaphysis of humerus.

This study aimed to anatomical stable reduction of fracture and prevention of injury to ulnar nerve.

We performed prospective study of 122 supracondylar humerus fracture type 3 in children by open reduction and internal fixation with crossed Kirshner wires over 7 years duration. The method of surgery was posterior triceps sparing. Diagnoses were made on Gartland's classification. To study the technique [triceps sparing approach] and evaluate results of open reduction internal fixation with cross k wires.

Average duration of follow up of each child was one year and on overall 94% of parents was satisfied with the results and 6% were unsatisfactory. Boys were more in number compared to girls and left elbow being more in incidence compared to right. Triceps sparing approach showed better elbow movements.

Our study concludes that posterior approach gives better visualization of fracture, the delineated ulnar nerve enables passing of k wires without injury.