Journal article
Clinical Characteristics of Severe Supracondylar Humerus Fractures in Children
Journal of pediatric orthopaedics, v 34(1), pp 34-39
01 Jan 2014
PMID: 23812149
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background:
The safety of delayed surgical treatment of severe supracondylar elbow fractures in children remains debated. No large studies have evaluated complications of injury and surgery evaluating only type 3 fractures. Our aim was to review the results of our experience treating children with severe supracondylar elbow fractures at various time points after injury.
Methods:
All children treated operatively for supracondylar humerus fractures from 2004 to 2007 at a single pediatric trauma center were identified. A total of 1296 children had operative treatment, of which 872 had type 3 fractures. Clinical records were reviewed to identify time to surgery from presentation at our institution. Patients were grouped into 4 cohorts [< 6 h (n=325), 6 to 12 h (n=224), 12 to 24 h (n=295), and > 24 h (n=28)]. Emergency, operative, inpatient, and outpatient records were reviewed to determine morbidity at presentation as well as operative and postoperative complications.
Results:
There was no difference in sex, age, or energy mechanism between children in the various time groups. An absent pulse was found in 54 children (6%) at presentation, of which only 5 ultimately required a vascular intervention. Nerve injury occurred in 105 patients (12%). Use of a medial entry pin was not associated with ulnar nerve injury. Increased time from presentation to surgery was not associated with increased morbidity from the injury or treatment complications. In contrast, there was a trend to steady decrease in morbidity and complication rates with increased time to surgery.
Conclusions:
This is the largest single-center study of severe supracondylar humerus fractures and describes rates of vascular compromise, nerve injury, infection, and other complications of these injuries. Most children with type 3 supracondylar humerus fractures can be treated safely in a delayed manner. Appropriate clinical judgment is imperative to optimize outcomes.
Level of Evidence:
Level III-retrospective comparative study.
Metrics
Details
- Title
- Clinical Characteristics of Severe Supracondylar Humerus Fractures in Children
- Creators
- Sumeet Garg - University of DenverAmanda Weller - Cardinal Glennon Children’s Medical CenterA. Noelle Larson - Mayo Clinic Rochester, MNNicholas D. Fletcher - Emory UniversityMichael Kwon - Drexel UniversityJonathan Schiller - Brown UniversityRichard Browne - Texas Scottish Rite Hospital for ChildrenLawson Copley - UT Southwestern, Childrens Med Ctr, Dallas, TX USAChristine Ho - Cardinal Glennon Children’s Medical Center
- Publication Details
- Journal of pediatric orthopaedics, v 34(1), pp 34-39
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 6
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics
- Web of Science ID
- WOS:000335836500006
- Scopus ID
- 2-s2.0-84890546902
- Other Identifier
- 991019168897904721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Orthopedics
- Pediatrics