Distal Humeral Fracture: An Epidemiological Analysis of Orthopedic Patients for Children

Fernandes, José Carlos Figueiredo; Milan, Taiuã Verdasca; Ribeiro, Helio Augusto Martins Ferreira; Stein, Haim; Ribas, Hamilton Carmargo; Carula, Beatriz Canhoto

doi:10.1590/1413-785220192705215825

Cited by 3 publications

(3 citation statements)

References 6 publications

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“…With reference to the patient cohort of this study of in total 971 patients, the female: male ratio was 1:1.2, as more male (523; 53.9%) than female (448; 46.1%) patients were treated for a supracondylar humerus fracture. This gender difference is also shown in previous studies that depicted a higher frequency of male patients by about 60% [ 3 , 5 , 6 , 8 , 18 . Apart from that, other studies describe an equal incidence [ 19 , 34 ] or even a female predominance as shown by LiBrizzi et al who referred to further studies showing this trend [ 35 , 36 ].…”

Section: Discussionsupporting

confidence: 85%

“…Supracondylar humerus fractures are one of the most common injuries in childhood and adolescence with an incidence of 14% [ 1 ]. In the elbow joint, supracondylar humerus fractures account for more than two-thirds of all injuries [ 2 , 3 ] and occur most frequently between the age of 5 and 7 years [ 4 , 5 , 6 ]. The gender distribution of patients with supracondylar humerus fractures as well as the eventual differences in injury mechanism, pattern, therapy and outcome are controversially discussed in the literature [ 5 , 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…In the elbow joint, supracondylar humerus fractures account for more than two-thirds of all injuries [ 2 , 3 ] and occur most frequently between the age of 5 and 7 years [ 4 , 5 , 6 ]. The gender distribution of patients with supracondylar humerus fractures as well as the eventual differences in injury mechanism, pattern, therapy and outcome are controversially discussed in the literature [ 5 , 7 , 8 ]. The most common cause of injury leading to supracondylar humerus fractures is children falling from various heights onto an outstretched arm [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Correlation of Fall Height, Fracture Severity and Clinical Outcome in Pediatric Supracondylar Fractures—A Retrospective Analysis with an Observation Period of 20 Years

et al. 2023

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The most common cause leading to supracondylar humerus fractures in children is falling onto an outstretched arm. A correlation between fall height and fracture severity may be assumed but has not yet been described. The aim of this study was to show that fracture severity increases with fall height. Furthermore, the correlation between fracture severity and outcome was examined. A total of 971 children with supracondylar humerus fractures between January 2000 and December 2019 were included in this study. The correlations between fall height and fracture severity and between fracture severity and outcome were assessed. Increasing fall height correlates with fracture severity (p < 0.001; r = 0.24). Furthermore, the incidence of complications increases with fracture severity and a correlation was present accordingly (p < 0.001; r = 0.28). A total of 30 (3.1%) patients showed limitations in range of motion and/or persistent neurologic deficits at the latest follow-up. Type I fractures rarely lead to subsequent limitations. The correlation between increasing fall height and fracture severity was significant. Furthermore, children with type III and IV supracondylar fractures are more likely to develop complications or restrictions in movement than children with type I and II fractures. Hence, the initial fall height may be an indirect indicator of a more or less favorable outcome.

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Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Correlation of Fall Height, Fracture Severity and Clinical Outcome in Pediatric Supracondylar Fractures—A Retrospective Analysis with an Observation Period of 20 Years

et al. 2023

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Are Postcast Removal X-rays and a Second Follow-up Necessary in the Treatment of Nondisplaced Supracondylar Humerus Fractures?

Zakrzewski

Ferrick²

2020

Journal of Pediatric Orthopaedics

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Background: The utility of routine follow-up radiographs for the treatment of nondisplaced pediatric supracondylar humerus fractures has not been established. The purpose of this study is to (1) determine the frequency that postcast removal x-rays change patient management and (2) determine the role of routine follow-up for range of motion evaluation after cast removal in the treatment of nondisplaced supracondylar humerus fractures. Methods: We conducted a single center retrospective chart review of patients under the age of 18 years old that sustained nondisplaced supracondylar humerus fractures between January 1, 2010 and July 1, 2018. Demographic information, fracture characteristics, time to follow-up and each appointment outcome were recorded. A change in patient management after postcast removal x-ray was defined as a need for an additional period of immobilization, a delay in initiation of range of motion exercises, or need for operative intervention. In addition, the appointment for range of motion evaluation was considered to alter management if further activity restriction was required, a formal physical therapy program was recommended or an additional office visit required. Unscheduled appointments were also noted. Results: A total of 489 patients met inclusion criteria. The average age was 4.90±2.68 years and 51.8% were female. A total of 487 patients had routine follow-up x-rays after cast removal. No patient had a change of management based on postcast removal radiographs. In all, 290 patients returned for range of motion follow-up with 94.8% of patients being discharged from care. There were 14 patients whose management changed based on this evaluation (4.8%). The most common reason was an additional appointment for range of motion evaluation (12/14 patients, 86%). There were 13 patients with unscheduled evaluation after discharge from care, 77% were secondary to repeat injury. Conclusion: This study suggests that postcast removal x-rays and routine follow-up after cast removal rarely change patient management and may not be necessary in the treatment of nondisplaced pediatric supracondylar humerus fractures. Level of Evidence: Level IV—case series.

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Caracterización de las fracturas supracondíleas del húmero en niños que requirieron manejo quirúrgico en un hospital de Santander, Colombia

Rueda Paez,

Manrique Hernández,

Guzmán Vargas

et al. 2023

MedUNAB

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Introducción. El objetivo del estudio fue describir las características sociodemográficas, tratamiento y complicaciones pre y posquirúrgicas de las fracturas supracondíleas del húmero distal en niños que requirieron manejo quirúrgico en un hospital de Santander, Colombia. Metodología. Se trata de un estudio observacional, descriptivo, de corte transversal con 58 pacientes que cumplieron los siguientes criterios de inclusión: edad entre 3 a 14 años, fracturas supracondíleas de manejo quirúrgico; como criterios de exclusión se tomó: antecedente de enfermedad ósea o neurológica previa y fracturas de más de 7 días de evolución. Para las variables continuas se usó medidas de tendencia central y dispersión, las categóricas en porcentajes y frecuencias absolutas. Resultados. La edad media de presentación fue de 6.2 años, el principal mecanismo de trauma fue caídas de altura con un 96.5%. El 65.5% provenía de zonas urbanas. El 13.8% se asoció con fracturas de antebrazo, y el 3.4% de epitróclea. La fijación se realizó en un 75% con técnica cruzada y un 17.2% se asoció con lesión iatrogénica del nervio ulnar. Discusión. En el estudio no se informaron lesiones vasculares; sin embargo, se documentó una alta prevalencia de lesión neurológica con la fijación medial, similar a lo descrito en la literatura (1.4%-17.7%); algunos autores describen técnicas que disminuyen estas lesiones hasta en un 0%. Conclusión. Las características sociodemográficas de nuestra población coinciden con la estadística publicada mundialmente; la principal complicación fue la lesión iatrogénica nervio ulnar, que se puede disminuir con un uso racional del pin medial y con el empleo de técnicas que busquen rechazar directamente el nervio.

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Distal Humeral Fracture: An Epidemiological Analysis of Orthopedic Patients for Children

Cited by 3 publications

References 6 publications

Correlation of Fall Height, Fracture Severity and Clinical Outcome in Pediatric Supracondylar Fractures—A Retrospective Analysis with an Observation Period of 20 Years

Correlation of Fall Height, Fracture Severity and Clinical Outcome in Pediatric Supracondylar Fractures—A Retrospective Analysis with an Observation Period of 20 Years

Are Postcast Removal X-rays and a Second Follow-up Necessary in the Treatment of Nondisplaced Supracondylar Humerus Fractures?

Caracterización de las fracturas supracondíleas del húmero en niños que requirieron manejo quirúrgico en un hospital de Santander, Colombia

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