Abstract：
OBJECTIVE: Open reduction is rarely performed in pediatric supracondylar humerus fractures. However, clear evidence is lacking regarding the optimal open approach to achieve satisfactory results. The anterior approach provides direct visualization of the fracture and excellent exposure to neurovascular structures, although its utilization is less common. The objective of this study was to review the indications, outcomes, and complications associated with the anterior approach for open reduction of these fractures.
METHODS: Our protocol was registered at PROSPERO: CRD42023446923. MEDLINE/PubMed, Embase, Web of Science, Clinicaltrials.gov, and Cochrane Library were searched from database inception to search date (December 2023) and screened in duplicate for relevant studies. Data were collected regarding patient demographics, indications for open reduction, Flynn\'s functional and cosmetic outcomes, and complications. Study quality was assessed using the Methodological Index for Non-Randomized Studies Criteria.
RESULTS: A total of 19 studies involving 483 patients were included. One study was classified as Level 2 evidence, ten as Level 3, and eight as Level 4. The mean MINORS score was 13.05±3.47. The primary indication for open reduction was failed closed reduction, observed in 46% of patients. 97.7% and 98.6% of patients achieved Flynn\'s functional and cosmetic satisfactory results, respectively. The postsurgical neurovascular injury rate was 1.4%. One patient required reintervention.
CONCLUSIONS: The anterior approach is safe and effective for managing pediatric supracondylar humerus fractures requiring open reduction.
METHODS: Systematic review of Level 2-4 evidence studies.
METHODS: Our protocol was registered at PROSPERO: CRD42023446923. MEDLINE/PubMed, Embase, Web of Science, Clinicaltrials.gov, and Cochrane Library were searched from database inception to search date (December 2023) and screened in duplicate for relevant studies. Data were collected regarding patient demographics, indications for open reduction, Flynn\'s functional and cosmetic outcomes, and complications. Study quality was assessed using the Methodological Index for Non-Randomized Studies Criteria.
RESULTS: A total of 19 studies involving 483 patients were included. One study was classified as Level 2 evidence, ten as Level 3, and eight as Level 4. The mean MINORS score was 13.05±3.47. The primary indication for open reduction was failed closed reduction, observed in 46% of patients. 97.7% and 98.6% of patients achieved Flynn\'s functional and cosmetic satisfactory results, respectively. The postsurgical neurovascular injury rate was 1.4%. One patient required reintervention.
CONCLUSIONS: The anterior approach is safe and effective for managing pediatric supracondylar humerus fractures requiring open reduction.
METHODS: Systematic review of Level 2-4 evidence studies.
摘要：
目的：小儿肱骨髁上骨折很少进行切开复位。然而,缺乏明确的证据表明，采用最佳的开放方法可以取得令人满意的结果。前路手术提供了骨折的直接可视化和对神经血管结构的良好暴露，虽然它的使用不太常见。这项研究的目的是回顾适应症，结果，以及与前路切开复位这些骨折相关的并发症。
方法：我们的方案在PROSPERO：CRD42023446923注册。MEDLINE/PubMed,Embase,WebofScience,Clinicaltrials.gov,和Cochrane图书馆从数据库开始到搜索日期（2023年12月）进行搜索，并一式两份筛选相关研究。收集了有关患者人口统计学的数据，切开复位的迹象，弗林的功能和外观结果，和并发症。使用非随机研究标准的方法学指数评估研究质量。
结果：共纳入19项研究，涉及483例患者。一项研究被列为二级证据,十为3级，八为4级。平均MINORS评分为13.05±3.47。开放还原的主要指征是封闭还原失败，在46％的患者中观察到。97.7%和98.6%的患者取得了Flynn的功能和美容效果满意,分别。术后神经血管损伤率为1.4%。一名患者需要再次干预。
结论：前路手术治疗需要切开复位的小儿肱骨髁上骨折是安全有效的。
方法：2-4级证据研究的系统评价。
方法：我们的方案在PROSPERO：CRD42023446923注册。MEDLINE/PubMed,Embase,WebofScience,Clinicaltrials.gov,和Cochrane图书馆从数据库开始到搜索日期（2023年12月）进行搜索，并一式两份筛选相关研究。收集了有关患者人口统计学的数据，切开复位的迹象，弗林的功能和外观结果，和并发症。使用非随机研究标准的方法学指数评估研究质量。
结果：共纳入19项研究，涉及483例患者。一项研究被列为二级证据,十为3级，八为4级。平均MINORS评分为13.05±3.47。开放还原的主要指征是封闭还原失败，在46％的患者中观察到。97.7%和98.6%的患者取得了Flynn的功能和美容效果满意,分别。术后神经血管损伤率为1.4%。一名患者需要再次干预。
结论：前路手术治疗需要切开复位的小儿肱骨髁上骨折是安全有效的。
方法：2-4级证据研究的系统评价。
