Complications associated with Pediatric Supracondylar Humeral Fractures

Abstract

Objective: To measure pediatric supracondylar fracture epidemiology, fracture rate, and complications in the island's pediatric population. The study aims to compare our results to the national rates reported in the literature.

Methods: In this retrospective record review we examined 330 patients who underwent open reduction internal fixation or closed reduction percutaneous pinning in pediatric supracondylar fractures at the University Pediatric Hospital of Puerto Rico Medical Center (HOPU). The study evaluated patients from January 2008 to January 2011 that had completed at least a 1 year follow-up. Measurement of type of fracture, and complications were recorded. Statistical significance was set at a p-valuevalue<0.05.

Results: Of the 330 patients, 206 (62%) were male and 127 (38%) were female. The average age was 5.49 years (± 2.43). The vast majority had extension-type fractures (98.2%) and 1.8% had flexion-type fractures. The neurological complication rates were 10% (33 patients). Neurologic complications after distal fragment displacement were 13.5% for posteromedial displacement versus 11.8% for posterolateral displacement, with a p-value of 0.71.

Conclusion: Our results in terms of female-to-male ratio, fracture type and complications (e.g., infection, vascular and neurologic complications) were similar to those reported in the literature. Because significant differences in the rates of posteromedial and posterolateral supracondylar fractures were found, we recommend further research on this subject. Overall, both our findings regarding complications and our results are similar to what has been reported in the literature. We can therefore affirm that our institution provides adequate care and management for this kind of fracture.

Keywords: Morbidity; Pediatric orthopedics; Pediatric supracondylar humerus fractures; Supracondylar fracture.