Satisfactory results likely after surgery for unstable supracondylar humerus fractures in children

A minimum 6-week follow-up of pediatric patients surgically treated for unstable supracondylar humerus fractures revealed satisfactory results in 92% of patients with type IV fractures.

“Although these fractures are associated with increased levels of technical difficulty, given the increased need for open reduction, utilization of medial pins, and longer surgical times, adequate reductions and satisfactory mid-tem to long-term outcomes can be achieved,” the authors wrote.

Researchers clinically and radiographically evaluated 130 children with completely displaced supracondylar humerus fractures (SCHF) that were treated during a 6-year period. The study included 12 patients with type IV fractures and 118 patients with type III fractures.

Findings showed 17% of patients with type IV fractures needed open reduction vs. 2% of patients with type III fractures. Medial pins were placed to supplement fixation in 42% of patients with type IV fractures and 17% of patients with type III fractures. Mean time to surgery was 0.9 days for type IV fractures and 1.1 days for type III fractures, and type IV fractures took about 22 minutes longer to fix in surgery. However, investigators noted all fractures studied sustained acceptable reduction and no patients needed reoperation.

No significant difference was seen between fracture types with regard to latest range of motion for the treated vs. the contralateral side. According to researchers, outcomes were satisfactory in 92% of patients with type IV fractures and in 98% of patients with type III fractures. ‒ by Monica Jaramillo

Disclosure: Silva reports he is a board or committee member of Pediatric Orthopaedic Society of North America.

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Source:

Silva M, et al. J Pediatr Orthop. 2015;doi:10.1097/BPO.0000000000000344.