Abstract / Summary
Supracondylar humerus fractures (SHFs) are commonly treated with closed reduction and percutaneous pinning (CRPP); however, open reduction is required in selected cases. To compare early functional and operative outcomes of anterior, lateral, and posterior open reduction techniques, using CRPP as a reference standard. This retrospective study included 60 pediatric patients with Gartland type III SHFs (CRPP, n = 15; anterior, n = 15; lateral, n = 15; posterior, n = 15). Outcomes included operative time, fluoroscopy use, union time, joint range of motion, Flynn functional and cosmetic scores, and complication rates. Compared with open techniques, CRPP demonstrated shorter operative time (30.5 ± 5.4 vs. 55.4 ± 7.2 min, P < 0.001), earlier union (28.6 ± 2.7 vs. 39.0 ± 5.9 days, P < 0.001), and superior cosmetic outcomes ( P < 0.001). Flexion limitation was greater in the open surgery group ( P = 0.030), while extension limitation was similar between groups ( P = 0.068). Functional Flynn scores did not differ significantly ( P = 0.151). Complication rates were low and comparable ( P = 1.000). Among open approaches, the posterior technique was associated with longer operative time, delayed union, greater motion limitation, and poorer functional and cosmetic outcomes ( P < 0.05 for all). Among open approaches, the anterior technique demonstrated more favorable early outcomes; however, these findings should be interpreted in the context of potential differences in fracture complexity between groups. CRPP remains the standard treatment and provides superior perioperative and cosmetic outcomes.