Comparison of Clinical Outcome Between Triceps-Splitting and Triceps-Sparing Posterior Surgical Approaches in The Supracondylar Humeral Fractures in Children.
Keywords:
Supracondylar humeral fractures, Triceps-spitting posterior approach, Triceps-sparing posterior approachAbstract
Supracondylar humeral fractures are the most common type of upper arm injury in children. The most cases require open reduction and internal fixation (ORIF). A variety of approaches can accomplish surgical exposure. An ideal surgical approach should enable safe and rapid reduction to obtain full anatomic alignment and lower rate of complication is also crucial. The purpose of this retrospective cohort study was to compare Triceps-splitting and Triceps-sparing posterior surgical approaches in treating supracondylar humeral fractures in children in terms of operative time, blood loss, according to the 6 month follow-up; radiological results, elbow range of motion. This study was conducted from August 2012 to December 2020 at Orthopedics department of Sawangdandin Crown Prince Hospital, Sakon Nakhon. Sampling comprised of 88 patients age less than ten years old with closed supracondylar humeral fracture and Gartland’s classification Type III. The patients were separated into two groups according to the surgical approach. Group I, 43 patients were treated with Triceps-splitting posterior surgery, and group II, 45 patients were treated with Triceps-sparing posterior surgery. Statistics analysis using descriptive statistics, Chi-square and independent T-test. The result was considered statistically significant if the two - sided p-value was less than 0.05.
Results: 88 patients from eight years collecting data, mean age 6.4 years old, male more than female. Group I Triceps-splitting posterior approach had shorter operative time compared with Triceps-sparing posterior approach (38 and 53 minutes, respectively with statistically significance p<0.001). No statistically difference was determined between the groups regarding intraoperative blood loss, radiological results, complication, elbow range of motion and clinical outcome at 6 months follow up.
Conclusion: Triceps-splitting posterior approach was as practical as the Triceps-sparing posterior approach but provided a shorter operative time in treating supracondylar humeral fractures in children. The outcomes will help surgeon to preterm surgical decision-making in the future treatment of supracondylar humeral fractures in children.
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