The treatment of distal humeral epiphyseal separation (DHES) in young children includes closed reduction and cast immobilization or fixation by Kirschner (K) wire with the assistance of an elbow joint arthrogram. In this study, we aimed to introduce and evaluate open reduction using an anterior transverse mini approach in the treatment of DHES in young children. We retrospectively analyzed the clinical data of patients diagnosed with DHES at our hospital between January 2015 and December 2019. After applying the inclusion and exclusion criteria, 70 patients were included in this study. The fracture type was classified using DeLee’s classification. The conservative group (14 patients; group A) underwent closed reduction and cast immobilization. Open surgery was performed using an anterior mini-transverse approach, and K-wires were used for fixation in group B (56 patients). After 3–5 weeks, the K-wires were removed following radiographic confirmation of callus formation. All elbow functions were evaluated using Flynn’s criteria. Complications such as cubitus varus, nerve palsies, incision infection, and K-wire skin irritation were analyzed. According to DeLee’s classification, in group A, five, four, and five patients were of types A, B, and C, respectively. In group B, 11, 10, and 35 patients were of types A, B, and C, respectively. There was a significant difference in Flynn’s criteria (P = 0.0007). In groups A and B, five and four patients developed cubitus varus, respectively, with a significant difference observed in the complication rate (P = 0.0127). Five patients developed K-wire skin irritation. Nerve injury was not observed in either group. One patient in group B had avascular necrosis of the trochlea. Open anatomic reduction via the anterior mini-transverse approach can be a choice of treatment for DHES in young children. Level of evidence: IV.

幼儿肱骨远端骨骺分离（DHES）的治疗包括闭合复位和石膏固定或在肘关节造影辅助下用克氏针（K）固定。在本研究中，我们旨在介绍和评估使用前路横行小入路切开复位治疗幼儿 DHES 的方法。我们回顾性分析了2015年1月至2019年12月期间在我院诊断为DHES的患者的临床资料。应用纳入和排除标准后，共纳入70例患者。骨折类型采用 DeLee 分类法进行分类。保守组（14 名患者；A 组）接受闭合复位和石膏固定。B组（56例）采用前路小横入路开放手术，克氏针固定。3-5周后，在X线证实愈伤组织形成后去除克氏针。所有肘部功能均使用弗林标准进行评估。分析肘内翻、神经麻痹、切口感染、克氏针皮肤刺激等并发症。根据DeLee分类，A组中A型、B型、C型分别有5例、4例、5例。B 组中，A 型、B 型和 C 型分别有 11 例、10 例和 35 例。Flynn 的标准存在显着差异（P = 0.0007）。A组和B组分别有5例和4例患者出现肘内翻，并发症发生率差异有统计学意义（P =0.0127）。五名患者出现克氏针皮肤刺激。两组均未观察到神经损伤。B组1例患者出现滑车缺血性坏死。通过前路小横入路进行开放性解剖复位可以成为治疗幼儿 DHES 的一种选择。证据级别：IV。