Procedural outcomes of double vs. single fluoroscopy for fixing supracondylar humerus fractures in children

The most common elbow fractures, especially in children under the age of 7 years, are supracondylar fractures. These injuries mostly caused by falling on an outstretched hand while elbow in extension or hyperextension [1]. Pediatric elbow fractures account for approximately 60% of upper extremity fractures and more than 13% of all pediatric fractures [2]. Supracondylar humerus fractures (SHF) of pediatric patients may be difficult to treat for an inexperienced specialist [3]. These types of fractures are divided into two types as extension and flexion [4]. Extension type fractures are seen in 95-98% of the patients and in 2-5% flexion type fractures are seen [4]. SHF is divided into 3 types according to the Gartland classification. Type 1 is stable and minimally displaced fracture, while type 2 and 3 are displaced fractures [5]. The treatment of SHF type 1 fractures is closed reduction and plaster application, percutaneous pinning method is preferred after either open or closed reduction in the treatment of Type 2 and Type 3 fractures [4]. Recently, double fluoroscopy method began to be used during the surgical procedures [6-8]. Double fluoroscopy was used in the nailing of intertrochanteric femoral fractures [6], Boszczyk et al. stated that using double scopy in kyphoplasty cases reduced the radiation exposure time [7]. Similarly, Peng et al. also stated that patients with pelvic trauma had less radiation exposure time in sacroiliac screw application with using double fluoroscopy [8]. There is not enough information about the usage of double fluoroscopy in the treatment of pediatric SHF. We hypothesized that radiological and functional results will be better in patients who were operated by using double fluoroscopy. In this study, we aimed to compare the functional, radiological results and also radiation exposure times of patients with SHF who were treated by double or single fluoroscopy.