ResultsĪll fractures united in a mean duration of 7.2 weeks (range 5–10 weeks) with no secondary displacement or mal-union. Functional outcome was evaluated according to the Mayo Elbow Performance Index (MEPI) and Mark functional criteria. The follow-up period ranged from 8 to 49 months, with a mean period of 17 months. All patients were completely evaluated clinically and radiologically before intervention, after surgery and during the follow-up. This prospective study included 15 children who had neglected displaced supracondylar and distal humeral fractures. The aim of this study is to evaluate the outcome of delayed open reduction using the triceps-sparing approach and Kirschner wire fixation for treatment of neglected, displaced supracondylar and distal humeral fractures in children. Traditionally, distal humeral fractures have been managed with surgical approaches that disrupt the extensor mechanism with less satisfactory functional outcome due to triceps weakness and elbow stiffness. In neglected cases, especially after early appearance of callus, there is no place for closed reduction and percutaneous pinning. However, the elbow may still be tense and swollen with abrasions or crusts. The neglected cases are often closed injuries with no vascular compromise. The delay is either due to lack of medical facilities or social and financial constraints. According to the literature, patients with neglected fractures are those patients who presented for treatment after 14 days of injury. However, between 10 and 20 % of patients present late. In cases of displacement and instability, the standard procedure is early closed reduction and percutaneous Kirschner wire fixation. Supracondylar humeral fractures are one of the most common skeletal injuries in children.
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