Epidemiological Features of Supracondylar Fractures of the Humerus in Chinese Children

Abstract

We studied 450 children with a supracondylar fracture of the humerus in the period 1991 to 1995, and were able to collect full management details in 403 of them (253 boys and 150 girls). The median age at presentation was 6 years (6.6 years in boys, and 5 years in girls), with the nondominant humerus 1.5 times more commonly injured. Fifteen percent of children presented more than 1 day after the injury. Garland type III fractures constituted 45% of cases, type I 30%, and type II 24%, with flexion type fractures present only in 1% of the children. A nerve injury was associated with the fracture in 19 cases. Although the radial pulse was not palpable at presentation in nine patients, only one child had diminished distal circulation requiring exploration. Concomitant fractures were present in 14 patients. Elbow hyperextension was greater than in a comparable group of noninjured children. Open reduction was necessary in 20% of these children, most being managed by manipulation under anaesthesia, at times associated with percutaneous Kirschner wiring. The hospital stay was 2 days or less in two-thirds of the patients, with more than 90% discharged home within 1 week of admission. In conclusion, many Chinese patients attend hospital later than their Western counterparts, and the rate of flexion-type injuries is low.

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“…Fall injury causes major injury. In our study it has been found that fall while playing and fall from bicycle causes maximum injury in the early group which is 33.33% while in the late group it was found that fall while playing causes maximum injury which is 42.1%, which is consistent with other studies [35][36][37][38][39] . In our study it was found that radial nerve was the commonest nerve involved, although slightly higher than described in the literature in early group (14.8%) and median nerve palsy (7.4%), while patients presenting late had no such complications [43][44] .…”

“…In our study age of the patients was 8.23± 2.981 years in early group and 7.84 ± 3.95 years in the late group which is nearly similar to the studies done by others [35][36] . Males were found to be more commonly involved both in early and late groups which are 63.0 % and 68.4 % respectively.…”

“…Significant co-relation has not been found as p-value < 0.249 which is consistent with study by Matuszweski L et al [42] . On further evaluation it has been found that non-dominant extremity is more commonly involved than dominant extremity which is consistent with a study by Farnsworth et al & Cheng et al [35,36] . Fall injury causes major injury.…”

“…Males were found to be more commonly involved both in early and late groups which are 63.0 % and 68.4 % respectively. Although some studies have concluded that females are more susceptible to such injures [35][36][37][38][39][40][41] . Both the early and late groups have been evaluated and it has been found that left upper limb extremity has been commonly involved, which is 74.1% in the early group and 57.9% in the late group.…”

Desvios rotacionais na fratura supracondiliana do úmero em crianças: novo método de avaliação

“…Dentre estas, as fraturas supracondilianas do úmero são responsáveis por até 50 a 70% dos casos (2)(3)(4) , acometendo principalmente crianças na faixa etária entre cinco e sete anos de idade (5) . As lesões ocorrem predominantemente à esquerda, ou do lado não dominante (5)(6)(7) .…”