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

Abstract

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.

Short-Term Management Outcomes of Supracondylar Fractures of the Humerus and Their Associated Factors in Children Managed at Mulago National Referral Hospital

“… 12 , 13 Neurovascular injury can lead to long-term disabilities and the cost of managing complications could go up to five times or more compared to the cost of the initial management. 13 , 14 …”

“…12,13 Neurovascular injury can lead to long-term disabilities and the cost of managing complications could go up to five times or more compared to the cost of the initial management. 13,14 Radiographic evaluation of the stage of a supracondylar humerus fracture is of paramount importance in the management of SCF of the humerus. 3,15 The lateral radiograph should be taken with the patient's arm flexed at a 90degree angle, the humerus horizontal and the elbow on the same plane with the shoulder and the wrist being in a lateral position.…”

Management of Pediatric Humeral Supracondylar Fractures in a Referral Center From a Developing Country: A Comparison With American Academy of Orthopaedic Surgeons (AAOS) Guidelines

“…With regard to the mechanism of injury, there is a notorious predominance of extension-type injuries. In a study of 159 patients, Barr [ 14 ] found that 155 presented extension-type injuries, and Baidoo et al [ 15 ] described that 96% of fractures were of the extension type. These findings are consistent with those of our study, which showed that flexion-type fractures are a rare entity, accounting for less than 2% of the cases.…”

“…These findings are consistent with those of our study, which showed that flexion-type fractures are a rare entity, accounting for less than 2% of the cases. In relation to the affected side, the referenced studies coincide in showing a predominance of the non-dominant side [ 13 - 15 ]. The present study found that 62% of injuries occurred on the left side, in line with the results described by Poulios et al [ 13 ] and Baidoo et al [ 15 ] in their publications.…”

“…In relation to the affected side, the referenced studies coincide in showing a predominance of the non-dominant side [ 13 - 15 ]. The present study found that 62% of injuries occurred on the left side, in line with the results described by Poulios et al [ 13 ] and Baidoo et al [ 15 ] in their publications.…”