Displaced Supracondylar Humerus Fractures in Children – Are They All Identical?
- Author:
Gera Sk, Ms Orth, Tan Mch, Mbbs, Lim Yg, Mrcs Ed, Lim Kbl, Frcsed Orth
- Publication Type:Article
- Keywords:
humerus supracondylar fracture, elbow fracture, paediatric, older child, adolescent
- From:Malaysian Orthopaedic Journal
2017;11(2):40-44
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: This study aims to ascertain if there are any
differences in supracondylar fractures between children
under seven years of age and those above 7 years of age.
Materials and Methods: All cases of displaced humerus
supracondylar fractures that required surgical stabilization
were identified and retrospectively reviewed. Demographic
data, mode of injury, associated neurovascular injuries and
details of surgery performed were obtained from clinical
records. The Gartland classification and the extent of
comminution of fractures were also documented from review
of radiographs.
Results: One hundred and twelve children were included in
this study, of whom 61 (54.46%) were younger than seven
years of age while 51 (45.5%) were aged seven years or
older. Children aged seven or older had a greater incidence
of associated neurological deficit at presentation (p=0.046).
Of the six patients with nerve injury in the older age group,
one patient (16.7%) had a radial nerve injury, two patients
(33.3%) had ulnar nerve injuries while another two patients
(33.3%) had median nerve injuries. There was one patient
(16.7%) with both median and ulnar nerve injuries.
Comminuted fractures were also more common in the older
children (p=0.004). No significant differences were
demonstrated between the groups with regard to age, gender
and mechanism of injury, laterality, incidence of open
fracture, vascular injuries and operative time.
Conclusion: Children aged seven years or older who sustain
supracondylar humeral fractures tend to get more
comminuted fractures. There is also a higher incidence of
associated neurological injury. These cases must be carefully
examined for at presentation and parents need to be
appropriately counselled about them.
