1200 Management of Supracondylar Fractures at a District General Hospital

Abstract

Aim The aims of the study were to identify supracondylar fracture cases, identify any differences in management between the pre- and post-COVID period, as well as compare local management to BOAST guidelines. Method Cases were retrospectively identified using electronic patient records, imaging, theatre records and clinic letters. Cases were identified between 1st of December 2019 – 30th December 2020. The Pre-COVID period was defined as before 15th of March 2020. The Post-COVID period was defined as after 15th of March 2020. Inclusion criteria: any paediatric supracondylar fracture requiring conservative or surgical management. Exclusion criteria: any adult cases. Data analysis and graphics were produced on Microsoft Excel. Results A total of 22 cases were identified. Time to operation Pre-COVID: 1 day vs Post-COVID 2 days (p < 0.05). Only 30% of cases had good neurovascular status documentation. Using the Gartland Classficiation – Type I:2, Type II:10, Type III:9, Type IV:1. Type of Fixation – MUA: 3, K-wires: 18, Plate and screws: 1. All Type I fractures were treated with K-wires. Cast duration for MUA 4 weeks vs K-wire 5 weeks (p-value< 0.05). Only 2/22 cases were referred to physiotherapy, whilst only 1 case required revision surgery. Conclusions MUA was not the treatment of choice for Type I fractures against BOAST guidelines. MUA offered a shorter duration in cast compared to K-wires. There was a statistically significant increase in time to operation between the Pre-COVID to Post-COVID Period. There is a need for better documentation for neurovascular status.