Paediatric supracondylar fractures: an overview of current management and guide to open approaches

Supracondylar fractures of the humerus are common fractures in children. Closed reduction and percutaneous pinning is the primary method of management, though 2–12% of these fractures require open reduction. There is no conclusive evidence to dictate the best surgical approach to the fracture. This paper aims to review supracondylar fractures of the humerus and discusses the early and late associated complications. The treatment options are then examined, with a focus on the preferred surgical approach to open reduction. If an orthopaedic surgeon is going to learn only one approach for reduction of these challenging fractures, then we recommend becoming familiar with the anterior approach. This is the approach one would need to use in most open fractures and in those where exploration of the brachial artery is indicated. It gives access to the neurovascular structures, to the fracture site and also to the soft tissues that are likely to block reduction. The cosmetic and functional outcomes are reported to be good.