Analysis of the treatment of supracondylar fractures of the pediatric humerus in a referral hospital
DOI:
https://doi.org/10.33448/rsd-v13i2.44944Keywords:
Arm; Postoperative complications; Humerus; Distal humerus fractures.Abstract
Objective: To evaluate the treatment profile of supracondylar fractures of the pediatric humerus in a referral hospital in northeastern Brazil. Methodology: This is a retrospective observational study of data on patients who were treated at a pediatric urgent and emergency care referral unit of the Brazilian National Health System (SUS) between July 2022 and June 2023. Patients under the age of 13 diagnosed with a supracondylar humerus fracture were included in the study. Results: 197 patients were assessed, with a mean age of 5.4 years. Of these, 88 patients underwent surgery (44.6%), with a mean age of 5.3 years at the time of surgery and a predilection for males (54.5%). Of the patients who underwent surgery, 10 (11.5%) had to undergo open reduction to properly position the fracture. The main fixation pattern in the sample was fixation with crossed Kirschner wires (65.9%) and the majority of fixations were carried out using 2 Kirschner wires (76.5%). There was a statistically significant association between fracture severity (Gartland types III and IV) and open reduction. No type II cases had complications, while 3 type III and 2 type IV cases had complications. Conclusion: The data obtained is in line with the worldwide literature, except for the lower frequency of the general surgical approach and the higher frequency of cross-fixation in this study.
References
Alayed, Y., Alrashedan, B. S., Almisfer, S. K., & Aldossari, A. M. (2023). Impact of preoperative neuropraxia on surgical duration following pediatric supracondylar fracture of the humerus: a retrospective cohort study. J Brachial Plex Peripher Nerve Inj, 18, e27-e31. https://doi.org/10.1055/s-0043-1771012
Aparicio Martínez, J. L., Pino Almero, L., Cibrian Ortiz de Anda, R. M., Guillén Botaya, E., García Montolio, M., & Mínguez Rey, M. F. (2019). Epidemiological study on supracondylar fractures of distal humerus in pediatric patients. Revista Española de Cirugía Ortopédica y Traumatología (English Edition), 63(6), 394-399. https://doi.org/10.1016/j.recot.2019.07.001
Barr, L. (2014). Paediatric supracondylar humeral fractures: epidemiology, mechanisms and incidence during school holidays. Journal of children 's orthopaedics. 8(2), 167-70. https://doi.org/10.1007/s11832-014-0577-0
Estrela, C. (2018). Metodologia Científica: Ciência, Ensino, Pesquisa. Editora Artes Médicas.
Fernandes Junior, J. C. F., Milan, T. V., Ribeiro, H. A. M. F., Stein, H. E., Ribas Filho, H. C., & Carula, B. C. (2019). Fratura distal do úmero: análise epidemiológica de pacientes ortopédicos infantis. Acta Ortopédica Brasileira, 27, 261-264. https://doi.org/10.1590/1413-785220192705215825
Gartland, J. J. (1959). Management of supracondylar fractures of the humerus in children. Surgery, gynecology & obstetrics, 109(2), 145-154.
Khoshbin, A., Leroux, T., Wasserstein, D., Wolfstadt, J., Law, P. W., Mahomed, N., & Wright, J. G. (2014). The epidemiology of paediatric supracondylar fracture fixation: a population-based study. Injury, 45(4), 701-708. https://doi.org/10.1016/j.injury.2013.10.004
Kropelnicki, A., Ali, A. M., Popat, R., & Sarraf, K. M. (2019). Paediatric supracondylar humerus fractures. British Journal of Hospital Medicine, 80(6), 312-316. https://doi.org/10.12968/hmed.2019.80.6.312
Leitch, K. K., Kay, R. M., Femino, J. D., Tolo, V. T., Storer, S. K., & Skaggs, D. L. (2006). Treatment of multidirectionally unstable supracondylar humeral fractures in children: a modified Gartland type-IV fracture. JBJS, 5, 980-985. https://doi.org/10.2106/jbjs.d.02956
Li, M., Xu, J., Hu, T., Zhang, M., & Li, F. (2019). Surgical management of Gartland type III supracondylar humerus fractures in older children: a retrospective study. Journal of pediatric orthopedics B, 28(6), 530. https://doi.org/10.1097/bpb.0000000000000582
Mubarak, F. S., Anzar, M. A. M., & Kanagratnam, K. (2023). Descriptive Study on Epidemiology, Clinical Presentation, Treatment, and Outcome of Supracondylar Fractures Treated in a Base Hospital of Sri Lanka: A Single-Center Study. Cureus, 15(6), e40494. 10.7759/cureus.40494.
Natalin, H. M., Silva, J. C. S. D., & Volpon, J. B. (2021). Comparison of two methods of fixation of supracondylar fractures of the humerus in children. Acta Ortopédica Brasileira, 29, 263-267. https://doi.org/10.1590/1413-785220212905240542
Patriota, G. S. Q. A., Assunção Filho, C. A., & Assunção, C. A. (2017). Qual a melhor técnica para fixação no tratamento de fratura supracondilar do úmero em crianças? Revista brasileira de ortopedia, 52, 428-434. https://doi.org/10.1016/j.rboe.2017.05.013
Rokaya, P. K., Karki, D. B., Rawal, M., Limbu, D., Menyangbo, S., & Devkota, H. (2020). Pattern of pediatric supracondylar fracture operated at a rural teaching hospital of Nepal: A descriptive cross-sectional study. Journal of the Nepal Medical Association, 58(223), 153. https://doi.org/10.31729/jnma.4869
Schuller, A., Hahn, S., Pichler, L., Hohensteiner, A., Sator, T., Jaindl, M., Schwendenwein, E., Tiefenboeck, T., & Payr, S. (2023). Correlation of Fall Height, Fracture Severity and Clinical Outcome in Pediatric Supracondylar Fractures—A Retrospective Analysis with an Observation Period of 20 Years. Children, 10(3), 510. https://doi.org/10.3390/children10030510
Tarabishi, M. M., Almigdad, A. K., Ganger, R., & Farr, S. (2023). Distal humeral corrective osteotomy for treatment of supracondylar fracture malunions in children. Journal of Children 's Orthopaedics, 17(3), 232-238. https://doi.org/10.1177/18632521231156942
Vaquero-Picado, A., González-Morán, G., & Moraleda, L. (2018). Management of Supracondylar Fractures of the Humerus in Children. EFORT Open Reviews, 3, 526-540. https://doi.org/10.1302/2058-5241.3.170049
Waters, P. M., Skaggs, D. L., & Flynn, J. M. (2020). Rockwood and Wilkins’ fractures in children/ [edited by] Peter M. Waters, David L. Skaggs, John M. (Jack) Flynn, Charles Court-Brown. Ninth edition. Wolters Kluwer.
Woratanarat, P., Angsanuntsukh, C., Rattanasiri, S., Attia, J., Woratanarat, T., & Thakkinstian, A. (2012). Meta-analysis of pinning in supracondylar fracture of the humerus in children. J Orthop Trauma, 26(1), 48-53. https://doi.org/10.1097/bot.0b013e3182143de0
Wu, J. P., Lu, Y. T., Wei, X. X., Zou, P. X., Li, Y. Q., Liu, Y. Z., Canavese, F., & Xu, H. W. (2023). Epidemiological characteristics and distribution of pediatric supracondylar fractures in South China: a retrospective analysis of 760 cases. Journal of Pediatric Orthopaedics B. https://doi.org/10.1097/bpb.0000000000001089
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Ana Helena Prado Santana Campos; Isadora Azarias Santos; Rafael Chaves Souza; Aécio Freire Monteiro; Mário Augusto Ferreira Cruz
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.