Elbow Fracture in Children at Saiful Anwar General Hospital, Nine Years Experiences

Abstract

AIM: The frequency, incidence, and types of fracture of the elbow are different between children and adult. The epidemiology of elbow fracture in children has been the subject of a limited number of studies. This study aims to observe the pattern of elbow fractures in children 18 years of age and younger, during a nine years period.
 METHODS: This is a retrospective study about elbow fracture cases in children 18 years old and younger treated in Saiful Anwar General Hospital Malang in the period of June 2009 until December 2018. The data obtained from the medical record include the age at the time of accidents, fracture site, type of lesion and ipsilateral injuries, time of accidents, and the mechanism of injury.
 RESULTS: There is a total of 99 elbow fracture, and there are 62 male (63%) and 37 female patients (37%). The mean age for the entire group is 7.3 years (8.1 years for male and 7.1 years for female). Most cases are supracondylar fracture (n=77, 78%). The supracondylar fracture is composed of 17 fracture classified to type II, and 60 fracture to type III as classified by Gartland. The most common etiology of fracture is associated with sports, recreational activities, and fall from height of less than two meters. Nerve injury involving the median, radial, and ulnar nerve is seen in eight patients with type III supracondylar fracture. Associated brachial artery injury is seen in four patients with type III supracondylar fractures. 78 patients (79%) were treated surgically and 21 patients (21%) were treated conservatively.
 CONCLUSION: The incidence of elbow fracture in children treated in Saiful Anwar General Hospital during a nine years period is 99 patients, with supracondylar fracture Gartland type III being the leading type of this group. Male patients are more common than female patients. Nerve injury was seen in 13.33% of cases and brachial artery injury was seen 6.67% with type III supracondylar fracture. Most of the elbow fracture in our institution were treated operatively.

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

“…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 ].…”

Epidemiologic investigation of pediatric distal humerus fractures: An American insurance claims database study

“…A 2013 Iranian study identified 8.1 ± 2.31 years old as the average age for all pediatric elbow fractures[ 25 ]. Similarly, an Indonesian study collecting data between 2009 to 2018 found the average age for all pediatric elbow fractures at 7.3 years[ 26 ]. In the American patient databases used, we did not observe any large age shifts from previous generations or for non-Western countries.…”

Lateral Humeral Condyle Fractures in Pediatric Patients

“…Lateral humeral condyle fractures account for 9.6–22.3% of all elbow fractures [ 1 , 2 , 4 , 5 , 6 , 7 , 11 , 12 , 13 , 14 ]. The majority (63–67.4%) of pediatric patients are male [ 8 , 9 , 13 , 14 , 15 ]. Most lateral humeral condyle fractures are seen between the ages of four and ten, but cases as early as 1.9 years have been reported [ 5 , 6 , 7 , 8 , 9 , 11 , 13 , 16 , 17 ].…”