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Flexion pattern injuries linked to poorer outcomes in children with supracondylar humerus fractures
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SAN DIEGO — Although researchers of a prospective study presented here found high levels of function among children who underwent surgery for supracondylar humerus fractures, they noted poorer outcomes for pain and mobility in patients who had flexion pattern injuries compared with extension pattern injuries.
“All of the patients in this cohort had very high levels of function as determined by [Pediatric Outcomes Data Collection Instrument] PODCI global function and QuickDASH scores,” Anthony I. Riccio, MD, said in his presentation at the Orthopaedic Trauma Association Annual Meeting. “Flexion type fractures do seem to be associated with poorer outcomes in the realms of pain and comfort and transfer and mobility, and no differences were found in the functional outcome measures between specific types of extension fractures or based upon directional displacement.”
Of 752 pediatric patients with supracondylar humerus fractures enrolled during a 3-year period, 199 patients completed both the QuickDASH and PODCI questionnaires. Riccio and colleagues classified fractures as either extension pattern injuries or flexion pattern injuries.
Overall, 5% of patients had flexion pattern injuries. Of the patients with extension injuries, 115 were type III fractures, 62 type II fractures and 12 were fractures deemed to be multidirectionally unstable at the time of operative intervention, according to Riccio. He noted high function among all patients “as determined by the PODCI global functioning score and very low levels of disabilities determined by the QuickDASH score.”
“When we compared our flexion type injuries to our extension type injuries, we found that patients with flexion patterns had significantly lower PODCI pain and comfort scores, and significantly lower PODCI transfer and mobility scores when compared to patients with extension injuries,” Riccio said.
He added, “We found no difference in outcome scores between patients with type II, type III and multidirectionally unstable fractures, and we found no difference in outcome scores based on the direction of displacement.” — by Casey Tingle
Reference:
Ernat J, et al. Paper #51. Presented at: Orthopaedic Trauma Association Annual Meeting. Oct. 7-10, 2015; San Diego.
Disclosure: Riccio reports that he received research support from Synthes and is a board member of the Pediatric Orthopaedic Society of North America.