Short-term Follow-up of Early Reconstructive Surgery Management in Neglected Supracondylar Humeral Fractures

Abstract

BACKGROUND: The supracondylar humeral fracture is a fracture located in the proximal position of the trochlea and humeral capitulum. This fracture is the most common elbow fracture in children. Epidemiological research states that these fractures constitute 58% of all elbow fractures in children. It is also mentioned that 10–20% patients undergo belated admission to get therapy. Based on the literature, the fracture is categorized as neglected if the fracture treatment is 14 days post-trauma. Unfortunately, few reports can provide management guidelines. Some experts mention the “wait and see” attitude toward this fracture until a perfect remodeling happens to correct the deformity; however, a number of studies have shown good results after early reconstruction.
 AIM: We aimed to evaluate the short-term follow-up of supracondylar humeral fractures that came after 14 days of injury and then open reduction reconstructions were done, followed by the installation of K-wire and screws with the figure of eight patterns based on the quick disabilities of the arm, shoulder, and hand (Q-DASH) 9-score, Flynn’s Criteria, and Mayo Elbow Performance Score (MEPS).
 METHODS: The samples were five patients who underwent corrective open reduction and injury fixed with Kirschner (K)-wire and screws with the figure of eight patterns using the posterior approach at the Orthopedic Hospital from December 2019 to February 2020. Results were assessed with the quick disabilities of the arm, shoulder, and hand-9 score (Q-DASH-9 score), Flynn’s Criteria, and Mayo Elbow Performance Score (MEPS).
 RESULTS: All patients after reconstruction correction showed an increase in range of motion in the fractured elbow. No complications were found from the surgical treatment.
 CONCLUSIONS: Early reconstruction correction of patients with supracondylar humeral fractures gave satisfactory results based on the Q-DASH-9 Score, Flynn’s Criteria, and MEPS.

Immediate Surgical Treatment in Neglected Open Left Supracondylar Humeral Fracture: A Case Report

“…The late case (neglected) is if the patient comes to the hospital roughly more than 2 days or more than 14 days after the fracture occurs. In our case the patient had Immediate treatment of supracondylar humeral fracture can decrease risk of its complication, including compartment syndrome, instability, and arthritis (Sumarwoto et al 2021). In other hand, not only delayed treatment has less favourable outcome (Guo et al 2020), but also leads to an increase in hospital stay length, resulting in additional costs (Yaokreh et al 2012).…”

“…Late presentation is defined as more than 2 days after injury or after 14 days of injury the patient presented for treatment, and objectively as the biological process of healing has already started with early callus formation and visible in x-rays but the fracture line is still visible (Rizk 2015;Shah et al 2016;Sumarwoto et al 2021).…”