UPPER LIMBClosed reduction and stabilization of supracondylar fractures of the humerus in children: the crucial factor of surgical experiencePadman, Manoj; Warwick, Andrea M.; Fernandes, James A.; Flowers, Mark J.; Davies, Anthony G.; Bell, Michael J.Author Information Department of Paediatric Orthopaedics and Trauma Surgery, Sheffield Children's Hospital, UK Correspondence to James A. Fernandes, FRCS Tr & Orth, Consultant Orthopaedic Surgeon, Sheffield Children's NHS Trust, Western Bank, Sheffield S10 2TH, UK Tel: +44 114 2717094; fax: +44 114 2267878; e-mail: [email protected] Journal of Pediatric Orthopaedics B: July 2010 - Volume 19 - Issue 4 - p 298-303 doi: 10.1097/BPB.0b013e328333ab18 Buy Metrics Abstract We reviewed the outcome following operative management of displaced (Gartland II and III) supracondylar fractures of the humerus in children over a 2-year period and tried to correlate the outcome with various factors including experience of the treating surgeon. Of the 71 children who formed the study group, 62 (87.3%) had a good outcome irrespective of the treatment modality. Closed reduction followed by plaster immobilization or percutaneous pinning resulted in a better outcome than open reduction. There was a direct involvement of the consultant in the primary management of these injuries in 17 cases (24%), none of which had a poor outcome. Of the 54 cases in whom the primary management was carried out independently by trainees without any consultant supervision, nine patients (17%) developed complications or needed reoperations. The proportion of unsatisfactory outcomes increased to 20.3% when failure to achieve a satisfactory reduction by closed means was also considered as a perioperative complication. There is a learning curve associated with percutaneous pinning after closed reduction and experience of the surgeon seems to be one of the factors that have an influence on the outcome. © 2010 Lippincott Williams & Wilkins, Inc.