Open reduction can be a reasonable, safe and effective choice in complex paediatric supracondylar humeral fractures operative treatment

Figure 2 Significant anterior elbow haematoma, pink pulseless hand and anterior interosseous nerve palsy in an 8-year-old male with a Gartland type IV supracondylar humeral. A: Clinical presentation; B: Radiological examination; C: Open reduction by lateral approach was unsuccessful due to periosteum and flexor muscles interposition on medial side requiring an enlarged medial approach and ulnar nerve exploration and protection; D: Four K-wires were applied (3 Lateral and 1 medial); E: K-wires were removed 5 weeks post-operatively. Normal pulses were palpable in hand 12 hours post-operatively and anterior interosseous nerve palsy recovered in 6 weeks.