Is Supine Position Superior to Prone Position in the Surgical Pinning of Supracondylar Humerus Fracture in Children?

BACKGROUND

Supracondylar humerus fracture (SCHF) is a frequent injury in pediatric ages. Closed reduction and percutaneous pin fixation is a common treatment of displaced SCHF. Surgery is usually performed in the supine position; otherwise the prone position allows an easier fracture reduction and a safe placement of pins. The aim of study is to compare the clinical and radiographic results of the treatment of displaced SCHF, comparing two different intra-operative positionings.

METHODS

59 SCHF affected children were retrospectively divided into supine (Group 1; = 34) and prone (Group 2; = 25), according to intraoperative position. All treated subjects were clinically evaluated according to Flynn's criteria and Mayo Elbow Performance Score, and radiographically, including the measurement of the Baumann angle.

RESULTS

Clinically, Group 1, according Flynn's criteria, had excellent cosmetic outcome in 32 subjects (94.1%). Mean MAYO Score was 96.0 ± 3.8. Group 2, according Flynn's criteria, had excellent cosmetic outcomes in 23 subjects (92.0%). Mean MAYO Score was 97.8 ± 3.3. Radiographically, mean difference of Baumann's angle between the injured limb and the normal limb was 5.5° ± 1.0° in Group 1 and 5.1° ± 1.1° in Group 2.

CONCLUSION

Both supine and prone positioning achieved a satisfying outcome with similar results in joint function recovery and complications.