Background and Objectives: Long-term outcomes of immediately postoperative rotational malreduction in the axial plane after operative treatment of supracondylar humeral fractures (SCHF) are unknown. This study aimed to investigate the long-term clinical outcomes and associated factors for immediately postoperative rotational malreduction of SCHF. Materials and methods: In this retrospective case–control study, 88 patients who underwent surgery for Gratland type III SCHF were enrolled between January 2012 and January 2020. Among them, 49 patients had immediately postoperative malrotational reduction (rotational malreduction group) and 39 patients had no rotational deformity (control group). To evaluate the associated factors for immediately postoperative rotational malreduction, demographic data, fracture patterns, physical examination signs, and preoperative radiological parameters were analyzed. To compare the clinical outcomes, operation time, range of motion of the elbow, time from operation to full range of motion, and Flynn criteria were evaluated. The Oxford elbow score was used to investigate long-term clinical outcomes for patients five years after operation. Results: The mean age was 5.7 ± 2.3 years and mean follow-up period was 15.7 ± 4.0 months. The rotational malreduction group had significantly more patients with oblique fracture pattern (p = 0.031) and Pucker sign (p = 0.016) and showed a significantly longer operative time (p = 0.029) than the control group. Although there was no significant difference in the range of elbow motion and the Flynn criteria, the Kaplan–Meier survival curve showed a longer time to recover the full range of elbow motion in the rotational malreduction group (p = 0.040). There were no significant differences in the long-term clinical outcomes assessed using the Oxford elbow score (p = 0.684). Conclusions: Oblique fracture pattern and Pucker sign may be associated with immediately postoperative rotational malreduction in the axial plane. Although patients with immediately postoperative rotational malreduction showed favorable results of long-term clinical outcomes, they required more weeks to recover the full range of elbow motion.

Background/Objectives: To evaluate the clinical and radiologic outcomes of arthroscopic augmented partial repair (APR) with acellular dermal matrix versus arthroscopic superior capsular reconstruction (SCR) in massive rotator cuff tears. Methods: The study included a total of 49 patients with massive rotator cuff tears who underwent arthroscopic APR (26 patients) and SCR (23 patients) between March 2018 and June 2021. Clinical scores, visual analog scores, and range of motion were collected preoperatively and postoperatively until the last follow-up. Preoperative and postoperative simple radiographs were evaluated for arthropathic changes and acromiohumeral distances (AHDs). Magnetic resonance imaging was performed to assess the integrity of repaired structures at 12 months postoperatively. Results: The average age of patients was 63.9 years (range 53–74 years), and the mean clinical follow-up period was 2.6 years (range 2.1–2.9). The average UCLA scores improved from 18.0 to 33.2 and from 16.3 to 32.1 in APR and SCR groups at the last follow-up, respectively. For the ranges of motion, the APR group consistently showed better external rotation ranges from the postoperative 6th month until the last follow-up (p < 0.05), and the APR group revealed better ranges of motion in forward flexion, abduction, and external rotation compared to the SCR group (p < 0.05). Postoperative AHD showed better improvement in the APR group than the SCR group (p < 0.05). Re-tears were found in two patients in each group (p > 0.05). Conclusions: Both APR and SCR groups showed comparable improvement in clinical outcomes in massive rotator cuff tears, while the APR group showed statistically significant improvement in the range of motion compared to the SCR group, especially for external rotations.