Open reduction and internal fixation for supracondylar humerus fractures in children.

Eight hundred sixty-two supracondylar humerus fractures were treated between January 1984 and July 1997. Sixty-five (8%) patients were managed with open reduction and internal fixation with pins. The remaining 797 patients (92%) were managed with either casting, closed reduction with or without percutaneous pinning, or traction. Of the 65 patients managed with open reduction, 46 (71%) of these fractures were irreducible, 16 (24%) had associated vascular compromise, eight (12%) were open, and one was associated with a postreduction nerve palsy and nonanatomic reduction. According to the criteria of Flynn et al. 18 (55%) elbows were rated excellent, eight (24%) were rated good, three (9%) were rated fair, and four (12%) were rated poor after an average of 5.8 months postinjury. This study indicates that highly satisfactory results can be obtained in severely displaced fractures managed with open reduction in these situations.