Pediatric supracondylar humerus fractures: Treatment by type of orthopedic surgeon

Abstract

Purpose Outcomes in children with supracondylar humerus fractures were stratified by type of treating orthopedic surgeon: pediatric orthopedic surgeon and nonpediatric orthopedic surgeon. Methods The outcome factors in 444 children examined included: open reduction rate, complications, postoperative nerve injury, repinning rate, need for physical therapy, and residual nerve palsy at final follow-up. Results For the severe fractures, significantly more fractures were treated by open reduction in the pediatric orthopedic surgeon group than in the nonpediatric orthopedic surgeon group. There were no other significant differences in outcomes between the fractures treated by the pediatric orthopedic surgeons and nonpediatric orthopedic surgeons. Conclusions This study supports the assertion that both pediatric and nonpediatric orthopedic surgeons in an academic setting have sufficient training, skill, and experience to treat these common injuries.

Radiographic Assessment in the Treatment of Supracondylar Humerus Fractures in Children

“…In group II, all subjects had extensional type of fractures. Comparing the data obtained in this study with the data found in other studies it can be said that the incidence of supracondylar fractures appear to be related to gender, age, side, and is consistent with the type of fracture (16). …”

“…The order of appearance is shown by mnemonic abbreviation: CRITOL (Capitulum, Radius, Internal or medial epicondyle, Trochlea, Olecranon, Lateral epicondyle). Age of occurrence is variable, but generally the sequence is at age of 1, 3, 5, 7, 9, 11 years (3, 4, 7, 10, 11, 12, 13, 14, 15, 16). Diagnosis of fractures of the distal humerus in children is a clinical and radiological.…”

Correlation Between Bauman's and Carrying Angle in Children with Supracondylar Fracture of Humerus

“…Supracondylar fractures of the humerus are the most common type of elbow fracture in children and adolescents and accounts for 16% of all fractures in childhood. In 60% of cases the fracture is on the left, usually the non dominant hand (8). Dislocated supracondylar fractures can lead to serious residual deformity if they are not reduced and stabilized in the optimum position.…”

Is outcome of delayed fixation is comparable with early fixation in type 3 supracondylar humerus fracture in children

“…Considering the severity of the injury, an immediate closed reduction is advised to minimize the possibility of further swelling leading to compartment syndrome and neurovascular compromise of the limb. Moreover, as the fixation is delayed, closed manoeuvre poses difficulties increasing the need for open reduction [2,4] . Open reduction is associated with severe disabling complications such as myositis ossificans, and stiffness of elbow, nerve and vascular injuries, and Volkmann's ischemic contracture (VIC) [5,6] .…”

“…This is a major factor responsible for significant delay in treatment initiation in some cases. A thorough literature search indicated that supracondylar fractures of the humerus in children is associated with some serious complications, including compartment syndrome which necessitates and benefits from an urgent treatment [2,4] . Though urgent treatment is necessary for supracondylar humerus fracture in childrens, Studies by Ahmed et al [4] , Mehlman et al [7] , Iyenger et al [8] , Leet et al [14] and Gupta et al [10] have shown that a delay in surgery of up to 32 hours does not significantly alter complication rates or the need for open reduction in children undergoing surgical treatment of supracondylar fractures of the humerus.…”