Managing supracondylar fractures of the distal humerus in children in a district general hospital

Pullagura, M; Odak, Saurabh; Pratt, R K

doi:10.1308/rcsann.2013.95.8.582

Cited by 6 publications

(3 citation statements)

References 15 publications

(22 reference statements)

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“…The eligible 49 studies all reported the proportion of cases with open and closed reduction 7,10,25-50,51-70 . The pooled overall proportion obtained for ORIF was 0.16 (95% CI = 0.14, 0.18; Table III; Fig.…”

Section: Resultsmentioning

confidence: 99%

Predictors Associated with the Need for Open Reduction of Pediatric Supracondylar Humerus Fractures

Transtrum,

Sanchez,

Griffith

et al. 2024

JBJS Open Access

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Background: Supracondylar humerus (SCH) fractures are some of the most common fractures in pediatric patients with surgery typically consisting of either open or closed reduction with internal fixation. The aim of this meta-analysis was to identify patient, injury, and administrative factors that are associated with treating pediatric SCH fractures with open techniques. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, PubMed and CINAHL database searches were conducted for studies from 2010 to 2023 that made direct comparisons between open reduction and internal fixation (ORIF) and closed reduction and percutaneous pinning (CRPP) for treating SCH fractures in the pediatric population. The search terms used were “pediatric” AND “SCH fracture” OR “distal humerus fracture.” Screening, quality assessment, and data extraction were performed by 4 reviewers. After testing for heterogeneity between studies, data were aggregated using random-effects model analysis. Results: Forty-nine clinical studies were included in the meta-analysis. Summated, there were 94,415 patients: 11,329 treated with ORIF and 83,086 treated with CRPP. Factors that were significantly associated with greater rates of ORIF included obesity (p = 0.001), Gartland type IV fractures (p < 0.001), general neurological deficits (p = 0.019), and ulnar nerve deficits (p = 0.003). Gartland type II (p = 0.033) and medially displaced fractures (p = 0.011) were significantly associated with lower rates of ORIF. Secondary analysis showed cross-pinning constructs (p = 0.033) and longer hospital stays (p = 0.005) are more likely to be observed in patients undergoing ORIF compared with CRPP. Conclusion: This meta-analysis demonstrates that factors such as obesity, fracture displacement, and concomitant nerve deficits are more likely to require ORIF as opposed to CRPP. Level of Evidence: Therapeutic Level III.

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Section: Resultsmentioning

confidence: 99%

Predictors Associated with the Need for Open Reduction of Pediatric Supracondylar Humerus Fractures

Transtrum,

Sanchez,

Griffith

et al. 2024

JBJS Open Access

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“…[5,14] Some studies that have evaluated outcomes and complications with respect to timing found no difference in the infection rate, neurovascular injury, length of hospital stay, or conversion to open reduction. [15][16][17][18] Others, however, recommended urgent fixation as any delays made the subsequent surgery difficult and raised the chances of complications. [19,20] In Ghana and most of the subregion, aside from patients with SCHF presenting late, others are taking to traditional bonesetters for management leading to permanent disability, and life and limb-threatening complications.…”

Section: Introductionmentioning

confidence: 99%

“…Some studies that have evaluated outcomes and complications with respect to timing found no difference in the infection rate, neurovascular injury, length of hospital stay, or conversion to open reduction [15–18] . Others, however, recommended urgent fixation as any delays made the subsequent surgery difficult and raised the chances of complications [19,20] .…”

Section: Introductionmentioning

confidence: 99%

Treatment and outcomes of pediatric supracondylar humeral fractures in Korle Bu Teaching Hospital

Baidoo

Kumah-Ametepey

Segbefia

et al. 2021

OTA International: The Open Access Journal of Orthopaedic Trauma

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Objectives: Supracondylar humeral fractures (SCHF) are the most common elbow injury in the pediatric population. The treatment, outcome, and health-related quality of life (HRQoL) following these injuries are described. Methods: Patients with SCHF who were treated depending on the fracture type were evaluated. Medical records stored in the REDCap database were reviewed to obtain information on demographics, mechanisms of injury, neurovascular status, infection rates, and postoperative complications. Outcomes were assessed using Flynn's criteria and Pediatric Quality of Life (PedsQL) version 4.0. Follow-up was for 6 months. Results: A total of 101 patients with a mean age of 5.2 years (SD ± 2.3) were seen. Most of the injuries occurred at home (64.3%). The left-arm (nondominant) was the most injured (62%), though 92% of patients were right hand dominant. Ninety-six percent of the fractures were the extension type. A total of 98% had satisfactory outcomes using Flynn's criteria and older patients were likely to sustain Gartland type III SCHF (P = .01). There was a significant difference in mean scores of PedsQL (all P values < .01) at 6 months. Conclusions: In this prospective study, the quality of life of patients following SCHF diminished at the time of the injury and returned to the population normal 6 months after. There was no significant difference in HRQoL scores between patients who presented early and those who presented late. The delayed presentation and management did not also affect the functional outcome and complications. Therefore, surgical management of these injuries after late presentation is still safe.

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Are we staying up too late? Timing of surgery of displaced supracondylar fractures in children. Clinical audit in a paediatric tertiary UK trauma centre and literature review

Abdelmalek

Towner

Clarke

2022

Arch Orthop Trauma Surg

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Managing supracondylar fractures of the distal humerus in children in a district general hospital

Cited by 6 publications

References 15 publications

Predictors Associated with the Need for Open Reduction of Pediatric Supracondylar Humerus Fractures

Predictors Associated with the Need for Open Reduction of Pediatric Supracondylar Humerus Fractures

Treatment and outcomes of pediatric supracondylar humeral fractures in Korle Bu Teaching Hospital

Are we staying up too late? Timing of surgery of displaced supracondylar fractures in children. Clinical audit in a paediatric tertiary UK trauma centre and literature review

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