Comparison of radiation exposure times in the treatment of pediatric supracondylar humeral fractures with open-closed reduction and internal fixation

• Published in: Acta orthopaedica et traumatologica turcica Vol. 43; no. 5; pp. 400 - 405
• Main Authors: Esen, Erdinç, Doğramaci, Yunus, Gültekin, Serap, Görmeli, Gökay, Yildirim, Ahmet, Kanatli, Ulunay, Bölükbaşi, Selçuk
• Format: Journal Article
• Language: English; Turkish
• Published: Turkey 01-11-2009
• Subjects: Child; External Fixators; Female; Humans; Humeral Fractures - diagnostic imaging; Humeral Fractures - surgery; Internal Fixators; Male; Radiography; Retrospective Studies
• ISSN: 1017-995X
• DOI: 10.3944/AOTT.2009.400

We compared open reduction-internal fixation (ORIF) and closed reduction-internal fixation (CRIF) with respect to operation and radiation exposure times in the treatment of displaced supracondylar humeral fractures in children.
This retrospective study included 124 children (76 boys, 48 girls) who underwent surgical treatment for displaced supracondylar humeral fractures (Gartland type 3). Of these, 52 patients (mean age 7.5 + or - 2.8 years) underwent ORIF, and 72 patients (mean age 6.1 + or - 2.5 years) underwent CRIF. Operation and fluoroscopy times were recorded in both groups. Final assessments included range of motion, varus- valgus angulation, neurovascular findings, and cosmetic appearance. Functional and cosmetic results were assessed using the criteria of Flynn et al. after a mean follow-up period of 49.3 + or - 18.6 months and 50.4 + or - 17.9 months in the ORIF and CRIF groups, respectively.
Radiographical union was obtained in all the patients within six weeks postoperatively. The two groups did not differ with respect to functional and cosmetic results (p>0.05), with excellent-good results accounting for 90.3% in the CRIF group, and 86.6% in the ORIF group. The mean operation times were 44.2 + or - 12.6 and 28.3 + or - 8.2 minutes, and the mean fluoroscopy times were 36.0 + or - 15.3 and 11.7 + or - 4.5 seconds, in the CRIF and ORIF groups, respectively, both being significantly longer in the former (p=0.000).
As extended fluoroscopy use increases radiation exposure, ORIF sems to be more convenient for the treatment of displaced supracondylar humeral fractures.