Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 May 15:9:139-42.
doi: 10.2174/1874325001509010139. eCollection 2015.

Complications and Predictors of Need for Return to the Operating Room in the Treatment of Supracondylar Humerus Fractures in Children

Matthew E Oetgen  1 , Gudrun E Mirick  1 , Lara Atwater  1 , John F Lovejoy  1
Affiliations

Complications and Predictors of Need for Return to the Operating Room in the Treatment of Supracondylar Humerus Fractures in Children

Matthew E Oetgen et al. Open Orthop J. .

Abstract

Supracondylar humerus fractures are common pediatric injuries. Little is known about the risk factors for repeat operative procedures. A retrospective chart review of 709 patients treated for a displaced supracondylar humerus fracture was performed to identify risk factors for return to the operating room during the initial post-operative period. Deviations of routine fracture care were recorded and complication rates were compared between Gartland type 2 and 3 fractures using logistic regression. Type 3 fractures were found to have a higher complication rate, and, specifically, more peri-operative nerve palsies, more likely to need to return to the operating room for hardware removal, to lose fracture reduction, and require a return to the operating room for any reason. Five risk factors which may require returning to the operating room were identified: younger patient age, left sided fractures, type 3 fractures, peri-operative nerve palsy, and post-operative infection. In conclusion, Gartland type 3 supracondylar humerus fractures are associated with more complications then type 2 fractures. Risk factors for the need to return to the operating room in the post-operative period include: younger patient age, left sided fractures, type 3 fractures, peri-operative nerve palsy, and post-operative infection. Patients with these risk factors should be considered at risk for return to the OR and fracture fixation and follow up protocols should be adjusted for this risk.

Level of evidence: Prognostic Study, Level II.

Keywords: Complications; Gartland classification; pediatric; pediatric elbow fracture; supracondylar humerus fracture.

PubMed Disclaimer

Figures

Fig. (1)
Fig. (1)
Total number of patients requiring return to the operating room for each patient age group.
See this image and copyright information in PMC

References

    1. Carson S, Woolridge DP, Colletti J, Kilgore K. Pediatric upper extremity injuries. Pediatr Clin North Am. 2006;53(1):41–67. - PubMed
    1. Bashyal RK, Chu JY, Schoenecker PL, Dobbs MB, Luhmann SJ, Gordon JE. Complications after pinning of supracondylar distal humerus fractures. J Pediatr Orthop. 2009;29(7):704–8. - PubMed
    1. Camus T, MacLellan B, Cook PC, Leahey JL, Hyndman JC, El-Hawary R. Extension type II pediatric supracondylar humerus fractures a radiographic outcomes study of closed reduction and cast immobilization. J Pediatr Orthop. 2011;31(4):366–71. - PubMed
    1. Skaggs DL, Hale JM, Bassett J, Kaminsky C, Kay RM, Tolo VT. Operative treatment of supracondylar fractures of the humerus in children.The consequences of pin placement. J Bone Joint Surg Am. 2001;83-A(5):735–40. - PubMed
    1. Gupta N, Kay RM, Leitch K, Femino JD, Tolo VT, Skaggs DL. Effect of surgical delay on perioperative complications and need for open reduction in supracondylar humerus fractures in children. J Pediatr Orthop. 2004;24(3):245–8. - PubMed

LinkOut - more resources