OBJECTIVETo explore minimally invasive surgical techniques for Gartland type III humeral supracondylar fracture in children and evaluate the outcomes of the patients.

METHODSWe retrospectively analyzed 62 children (43 boys and 19 girls, aged 1 year and 8 months to 13 years and 2 months, mean 6 years and 3 months) with Gartland type III humeral supracondylar fracture treated in our department from July, 2011 to September, 2013, including 42 with extension-ulnar type humeral supracondylar fracture and 20 with deviation-ulnar type. The injury to operation time ranged from 6 to 48 h with a mean of 13.5 h. Close reduction and percutaneous pinning internal fixation was performed by a single surgeon in all cases with plaster cast fixation for 3 to 4 weeks. The patients were followed up regularly and Flynn elbow scoring criteria was used to evaluate the outcomes.

RESULTSThe mean operation time was 26.8 ± 15.6 min with a mean intraoperative fluoroscopy frequency of 9.2 ± 2.6 and a mean follow-up for 16.5 months (6 to 30 months). Clinical healing was achieved in 3 to 4 weeks without fracture displacement after removal of the internal fixation, and active and passive functional exercise was initiated. According to the Flynn elbow scoring criteria, excellent outcome was achieved in 53 (85%) cases at 3 months in 62 (100%) cases at 6 months after the surgery. No such complications as osteofascial compartment syndrome or vascular injuries occurred in these patients. Three children had alnar nerve injury symptoms after the operation but all recovered in 3 months.

CONCLUSIONThe minimally invasive method with closed reduction and percutaneous pinning internal fixation is feasible for treatment of Gartland type III humerus condyle fracture in children. This approach involves relatively simple operation with shorter operation time, minimal trauma, and less complications after operation, and promotes early functional recovery of the elbow joint.