Patient Demographics and Risk Factors in Pediatric Distal Humeral Supracondylar Fractures

Mitchelson, Andrew J; Illingworth, Kenneth D.; Robinson, Brooke S; Elnimeiry, Khider A K; Wilson, Craig J.; Markwell, Stephen; Gabriel, Keith R.; McGinty, Jasmin L.; Saleh, Khaled J.

doi:10.3928/01477447-20130523-12

Cited by 28 publications

(33 citation statements)

References 34 publications

(74 reference statements)

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“…Monkey bar falls are the most common cause of playgroundrelated supracondylar fracture. In the same four studies totaling 1,671 supracondylar fractures, 144 were the direct result of falls from monkey bars (7.5%) [4,[8][9][10][11]. Another common culprit resulting in supracondylar fractures are trampoline falls.…”

Section: Mechanism Of Injurymentioning

confidence: 99%

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Epidemiological Analysis of Displaced Supracondylar Fractures

Pilla

Rinaldi

Hatch³

et al. 2020

Cureus

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Introduction: Supracondylar fractures are one of the most common fracture patterns sustained by children, and one of the most common injuries requiring operative fixation. Understanding the complications associated with supracondylar fractures is vital for the practicing orthopedic surgeon. This analysis of supracondylar fractures examined the clinically important aspects including vascular injury, compartment syndrome, neurological injury, brachialis entrapment, associated injuries, and etiologies of injury. Recent advances in technology have resulted in a myriad of new forms of recreational equipment for children to play with. The purpose of this study is to compare the historical literature, the current literature, and a single surgeon's sample of supracondylar fractures. In addition, this study aims to evaluate if any changes in epidemiology or etiology have occurred due to the development of new recreational equipment. Objective: The purpose of this study is to evaluate and provide a qualitative overview of the epidemiology of displaced supracondylar fractures, to compare historically reported numbers to more recent literature as well as a single surgeon sample, and to evaluate if changes in epidemiology or etiology have occurred due to the new recreational equipment that children use. Methods: Some 75 displaced supracondylar elbow fractures were reviewed. Data elements recorded from the electronic medical record (EMR) included patient age, gender, height, weight, handedness, date, time, location, mechanism, Gartland classification, concurrent injuries, and neurovascular status. Results: In this study, there were 42 males and 33 females. The average age was six years. Some 70 of the 75 patients were older than the age three. One fracture was open, nine fractures had a pucker sign, seven presented with a nerve palsy, four presented without a pulse, and seven patients presented with an additional ipsilateral distal radius fracture. All fractures were the result of a fall. Falls from playground equipment resulted in 29 fractures. There were 10 from falls off of furniture, six from falls during sports, three from falls on the stairs, and three from fall off of bikes. The remaining fractures resulted from running, tripping, falling from a toy ball, sled, tree, wagon, fence, bounce house, van, deck, power wheels car, ATV, and a go-cart. Some 64 fractures were transferred from 27 different outside hospitals. Eleven fractures presented directly to the ED. Twenty-six fractures occurred during the summer, 20 occurred in the autumn, 6 occurred in the winter, and 23 occurred during the spring. Some 35 fractures occurred at home, 30 on the school grounds, four in a gymnasium, four in a park, one at a farm show, and one in a parking lot. Some 25 fractures were treated between midnight and 8 am, 16 were treated between 8 am and 5 pm, and 34 were treated between 5 pm and 1 2 3 4

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Section: Mechanism Of Injurymentioning

confidence: 99%

“…Another common culprit resulting in supracondylar fractures are trampoline falls. In three studies totaling 1,237 supracondylar fractures, 128 were the result of a fall from a trampoline (10%) [8][9][10]. Monkey bars and trampolines alone account for between 15% and 20% of supracondylar fractures.…”

Section: Mechanism Of Injurymentioning

confidence: 99%

Epidemiological Analysis of Displaced Supracondylar Fractures

Pilla

Rinaldi

Hatch³

et al. 2020

Cureus

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“…Supracondylar fracture of the humerus is the most common elbow injury in children. [ 1 , 2 ] Most of these fractures are treated with closed reduction followed by percutaneous pinning (CRPP); [ 1 , 3 ] however, the clinical outcome is occasionally deteriorated by postoperative complications such as cubitus varus deformity, restricted range of motion (ROM), pin tract infection, or neurovascular disturbance. [ 3 – 5 ] Cubitus varus deformity is the most common residual deformity after supracondylar fracture of the humerus in children.…”

Section: Introductionmentioning

confidence: 99%

Clinical results of closed versus mini-open reduction with percutaneous pinning for supracondylar fractures of the humerus in children

Tomori¹,

Nanno²,

Takai³

2018

Medicine

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To compare the clinical outcomes of 2 procedures, closed or mini-open reduction with percutaneous pinning (ORPP), for the treatment of supracondylar fractures of the humerus in children.Patients aged less than 15 years who had undergone surgery for supracondylar fracture of the humerus between 2004 and 2013 were identified. The case records and radiographs from 34 patients were reviewed. Twenty-one patients had undergone closed reduction followed by percutaneous pinning (CRPP), while 13 had undergone mini-open reduction through the anterior approach with percutaneous pinning (mini-ORPP). The average age of the patients at the time of surgery was 5.4 (1–13) years in the CRPP group and 5.4 (2–9) years in the mini-ORPP group. The average age of the patients at the time of surgery was 5.4 (1–13) years in the CRPP group and 5.4 (2–9) years in the mini-ORPP group. Based on the Gartland classification system, the CRPP group included 12 type 2 and 9 type 3 fractures, while the mini-ORPP group included 4 type 2 and 9 type 3 fractures. The average postoperative follow-up duration was 8 (3–21) months in the CRPP group and 10 (3–10) months in the mini-ORPP group. The investigated parameters were postoperative complications, radiographic evaluation, and clinical evaluation, including range of motion (ROM) and Flynn's criteria. To evaluate the deformity of the humerus, Baumann's angle and the carrying angle (CA) were calculated on anteroposterior radiographs.Although no patient showed loss of reduction, deep infection, or neurovascular complications, 1 patient in the CRPP group had a cubitus varus deformity. The average CA loss in the injured elbow compared with the CA of the contralateral side was significantly larger in the CRPP group than the mini-ORPP group. In accordance with Flynn's criteria, the results in the CRPP group were excellent in 12 patients, good in 8, and poor in 1; the results in the mini-ORPP group were excellent in 12, and good in 1.To eliminate the possibility of postoperative cubitus varus deformity, the mini-ORPP is the optimal procedure for supracondylar fracture of the humerus in children.

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“…Unlike most paediatric fractures, which increase in incidence up to the age of 12, the average age at time of fracture is 6.7 years [1,2,4] . They are classified according to Wilkins' modification of the Gartland classification [5] : Type I (undisplaced) accounting for 52%, Type IIa (displaced but with an intact posterior cortex and no rotational displacement) and Type IIb (same as Type IIa but with rotational displacement) accounting for 24% and Type III (displaced with no cortical continuity) accounting for 24% [3,6] (Figure 1). A type IV pattern has been proposed [7] , which in addition to complete loss of cortical contact, describes instability in flexion and extension as assessed intra-operatively or under image guidance and may prove useful for operative decision making.…”

Section: Introductionmentioning

confidence: 99%

“…• Not related to the humerus (6) • Not available in English Language (4) • Conference abstracts (4) • No long-term follow up (3)…”

Section: Introductionmentioning

confidence: 99%

Sagittal Plane Malalignment in Paediatric Supracondylar Fractures of the Distal Humerus: A Review of the Literature

Rashid

Abdul-Jabar²,

Bretherton

et al. 2016

International Journal of Orthopaedics

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AIM: Sagittal plane malalignment in supracondylar fractures of the humerus is thought to remodel well and be of doubtful functional significance. Consequently it has been given little attention. Our aim was to review the contemporary literature for consensus about the optimal radiographic method to assess sagittal plane alignment, define acceptable limits of reduction in this plane and assess the functional consequences of the ensuing hyperextension deformity. METHODS: A search of MEDLINE(Ovid), PubMed, EMBASE, CINAHL and the Cochrane & DARE databases for "supracondylar fracture*" AND "sagittal" OR "anterior humeral line" OR "humerocapitellar angle" was conducted in October 2013. RESULTS: The search identified 42 articles. Of these, 13 papers evaluated optimal radiological parameters or patient outcomes in supracondylar fractures with reference to sagittal plane deformity. CONCLUSIONS: Inadequate reduction of supracondylar fractures in the sagittal plane results in loss of elbow flexion, although it may not be significantly disabling. The humerocapitellar angle has better reliability and prognostic value than any other radiographic measurement, but should not be used in isolation. In children under the age of 6 a humerocapitellar angle of 42 degrees +/-18 degrees is

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Patient Demographics and Risk Factors in Pediatric Distal Humeral Supracondylar Fractures

Cited by 28 publications

References 34 publications

Epidemiological Analysis of Displaced Supracondylar Fractures

Epidemiological Analysis of Displaced Supracondylar Fractures

Clinical results of closed versus mini-open reduction with percutaneous pinning for supracondylar fractures of the humerus in children

Sagittal Plane Malalignment in Paediatric Supracondylar Fractures of the Distal Humerus: A Review of the Literature

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