Open reduction and bioabsorbable pin fixation for late presenting irreducible supracondylar humeral fracture in children

The objective was to evaluate the availability and efficacy of internal fixation with absorbable poly-D,L-lactic acid (PDLLA) pins for the treatment of late presenting irreducible Gartland type III supracondylar fracture of the humerus in children. Fifty-six cases of late presenting irreducible Gartland type III supracondylar fracture of the humerus in children were treated by open reduction and bioabsorbable PDLLA pin fixation from March 2005 to March 2008. The outcome of treatment was evaluated by the Mayo Elbow Performance Score (MEPS) and the criteria of Flynn. Fifty-six patients were followed up from 24 to 36 months (mean: 22 months). No displacement of bone fracture occurred, and all fractures healed within a normal time without wound infection; there were no cases of Volkmann's ischaemic contracture, myositis ossificans or iatrogenic injury of the ulnar nerve. No residual vascular deficits or iatrogenic nerve injury were noted; cubitus varus deformity occurred in one case. There were 49 excellent, four good and three fair results according to the MEPS; the rate of excellent and good outcome was 94.6%. All children but one had excellent cosmetic results according to the criteria of Flynn. All of the children and their parents stated that they would choose this treatment again. Treatment of late presenting irreducible Gartland type III supracondylar fracture of the humerus in children with bioabsorbable PDLLA pins provides sufficient stability and satisfactory efficacy. The absorbable implant has become popular for its avoidance of a second operation to remove the internal fixation, and the degree of patient satisfaction is high.