Open Reduction of Paediatric Supracondylar Humerus Fractures has No Negative Impact on Long-term Functional Outcome and Quality of Life Compared to Closed Reduction

Abstract

Aim of the Study

The aim of the study was to compare closed and open reduction of displaced paediatric supracondylar humerus fractures with regard to long-term functional outcome and quality of life.

Material and Methods

In this retrospective study, 30 patients were examined with a displaced supracondylar humerus fracture (14 boys and 16 girls with a median age of 7 years [5–12 years]). The right elbow was affected in 8 cases (27%) and the left elbow in 22 cases (73%). According to the Gartland/Wilkins classification, there were 3× type IIA (10%), 8 × type IIB (27%), 18 × type III (60%) fractures (missing data n = 1 [3%]). All fractures were fixed with a crossed K-wire osteosynthesis. In the 1st group (n = 12), the fractures were reduced closed. In the 2nd group (n = 18), an open reduction was performed. The Quick Disabilities of the Arm, Shoulder and Hand Score (Quick-DASH) and the Paediatric Quality of Life Score (PedsQL) were recorded as outcome parameters after a mean follow-up of 53 months. The two groups were compared in terms of patient- and treatment-related factors and outcome parameters.

Results

The proportion of right elbow fractures was significantly higher in group 1 than in group 2 (50% vs. 11%). In group 2, the proportion of more severely displaced fractures was significantly higher than in group 1 (Gartland/Wilkins type III: 98% vs. 17%) and the median operating time was significantly longer (93 min vs. 26 min). There were no significant differences between the two groups in the Quick-DASH (0 [0–39] vs. 0 [0–11], p = 0.219), in the additional module “Sports and Music” of the Quick-DASH (0 [0–37.5], missing data n = 2, vs. 0 [0–50], p = 0.284) and in the PedsQL (95 [63–100] vs. 96 [86–100], p = 0.328).

Conclusion

Open reduction of displaced paediatric supracondylar humerus fractures does not lead to a reduction in long-term functional outcome and quality of life compared to closed reduction.

Keywords

supracondylar - humerus - fracture - outcome - reduction

Publication History

Received: 11 April 2025

Accepted after revision: 16 June 2025

Article published online:
16 July 2025

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