Posterior bilaterotricipital approach for surgical treatment of children’s Gartland Type III supracondylar humeral fractures

Effects of posterior bilaterotricipital approach on the outcome of range of motion and carrying-angle of the elbow after open reduction and internal fixation of children’s Gartland Type III supracondylar humeral fractures were evaluated. Twenty-five patients (18 boys, 7 girls; mean age 11.2) with Gartland Type III supracondylar humeral fractures, who needed open reduction, were operated through posterior bilaterotricipital approach in our institution between the years 2000 and 2007. At the final follow-up examination, patients were questioned about pain, restriction in motion and satisfaction with the appearance of the elbow. Carrying-angles and flexion–extension arcs of the elbows were measured. Change in carrying-angle of the operated elbow was zero to 5° in 19 (76%), 6°–10° in four (16%) and 11°–15° in two (8%) patients. Fourteen (56%) patients lost less than 5°, eight (32%) lost 6°–10°, two (8%) lost 11°–15° and one (4%) lost more than 15° of movement in flexion–extension arc. According to Flynn criteria, excellent results were obtained in 12 (48%), good results in nine (36%), fair results in three (12%) and poor result in one (4%) of the patients at meanly 32.4 months follow-up. Satisfactory results can be obtained by using posterior bilaterotricipital approach for the surgical treatment of Gartland Type III supracondylar humeral fractures, which needed open reduction and internal fixation.