Quality of Reduction Versus Timing of Surgical Intervention for Pediatric Supracondylar Humerus Fractures

Carmichael, Kelly D.; Joyner, Kyle

doi:10.3928/01477447-20060701-13

Cited by 63 publications

(35 citation statements)

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“…The results of our study confirm that perioperative complications, risk of conversion to open reduction, and functional outcomes are not significantly different when surgery is delayed more than 12 hours after injury. These findings are consistent with previous reports 2–4,16 .…”

Section: Discussionsupporting

confidence: 94%

“…Traditionally, emergency treatment has been thought to be helpful in reducing perioperative complications, although there has been no convincing proof of this. Recently some authors have suggested that there are no significant differences between early and delayed surgery in regard to complications and functional outcomes 2–8 . However, it has not been clear whether surgical timing affects the results of open surgery, such surgery not being routinely undertaken.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of complications and results of early versus delayed surgery for Gartland type III supracondylar humeral fractures in pediatric patients

Han

Wang

Liu

2011

Orthopaedic Surgery

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Section: Discussionsupporting

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Comparison of complications and results of early versus delayed surgery for Gartland type III supracondylar humeral fractures in pediatric patients

Han

Wang

Liu

2011

Orthopaedic Surgery

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“…Согласно недавним исследованиям при закрытом переломе Гартланда III типа без нервно-сосудистых повреждений пациент имеет хороший прогноз, если операция проводилась в плановом, а не в экстренном порядке [43]. Carmichel et al [43] отметили, что в большинстве случаев подобных переломов пациенты не нуждаются в экстренной  Ортопедия, травматология и восстановительная хирургия детского возраста. Том 7.…”

Section: Discussionunclassified

Does the timing of surgery affect outcomes of gartland type III supracondylar fractures in children?

Shon¹,

Kim²,

Shin³

et al. 2019

Pediatr Traum Orthop Reconstr Surg

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Background. Gartland type III supracondylar fractures in children are treated as emergency. But there are few studies about surgical timing and clinical outcomes. Aim. To evaluate whether the time interval from injury to surgical treatment affects the treatment outcomes of Gartland type III supracondylar fractures in children. Methods. The study population comprised all children presenting to our hospital between April 2003 and December 2013, who had Gartland type III supracondylar humerus fracture. Patients were divided into three groups: those who were treated within less than six hours from injury, those who were treated between six and twelve hours, and those who were treated between twelve and twenty four hours after injury. In this retrospective study, we checked whether the timing of surgery affected clinical outcomes such as bone union, range of motion, peri-operative complications, and operation time. Results. All patients were treated with closed reduction and percutaneous pin fixation within 24 hours. This study showed a trend that the delay in the timing of surgery after traumatic injury increases operation time, however with no statistical differences. The neurological complications were similar in the three groups. There were 11 cases (14.7%) of preoperative neurologic deficit, however every patient recovered postoperatively. There was no difference between the three groups in terms of clinical outcomes such as range of motion of the elbow and bone union. Conclusion. For Gartland III pediatric supracondylar humerus fractures, operation can be delayed for up to 24 hours, which may allow time for operation during regular hours, rather than late at night, with thorough evaluation of circulation, nerve injury, and swelling.

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“…Supracondylar fractures of the humerus are the most common fracture of the elbow in children. The majority of these fractures (96–98 %) are extension-type fractures [ 1 – 4 ]. Gartland originally described a classification for extension-type supracondylar humerus fractures, dividing them into three types: type I is non-displaced, type II is displaced with an intact posterior cortex, and type III is displaced without cortical contact [ 2 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Gartland type III supracondylar humerus fractures: Outcome and complications as related to operative timing and pin configuration

Abbott

Buchler

Loder

et al. 2014

Journal of Children's Orthopaedics

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PurposeSupracondylar fractures of the humerus are the most common fracture of the elbow in children. The purpose of this study was to evaluate, in terms of outcomes and complications, Gartland type III pediatric supracondylar humerus fractures treated at a pediatric level-one trauma center over a 7-year period, specifically addressing the impact of time to surgery on the incidence of complications and conversion to open reduction.MethodsWe retrospectively reviewed 297 pediatric patients that sustained a closed Gartland type III supracondylar humerus fracture treated between December 2004 and December 2011. The time to the operating room was calculated from the medical records for each patient. The outcome measures evaluated were operative time, conversion to open procedure, and perioperative and postoperative complications.ResultsIn our study, there were 30 complications in 25 children (8.4%). Conversion to open reduction occurred in 28 children (9.4%). The time from the emergency department to the operating room was not significantly correlated with increased complications, increased operative time, or conversion to open reduction (p > 0.05). Crossed pinning resulted in an increased risk of overall complications [odds ratio (OR) = 2.6] and iatrogenic nerve injuries (OR = 9.3). Complications also occurred more commonly in boys (OR = 3.3) and in older patients (p = 0.0069)ConclusionsWe found no significant correlation between the time to surgery and complications, operative time, or need for open reduction. These findings support the trend of treating Gartland type III supracondylar humerus fractures in a less urgent manner. In addition, our study supports the concept that cross pinning leads to more complications than lateral pinning, including an 8-fold increase in iatrogenic nerve injury.

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Quality of Reduction Versus Timing of Surgical Intervention for Pediatric Supracondylar Humerus Fractures

Cited by 63 publications

References 0 publications

Comparison of complications and results of early versus delayed surgery for Gartland type III supracondylar humeral fractures in pediatric patients

Comparison of complications and results of early versus delayed surgery for Gartland type III supracondylar humeral fractures in pediatric patients

Does the timing of surgery affect outcomes of gartland type III supracondylar fractures in children?

Gartland type III supracondylar humerus fractures: Outcome and complications as related to operative timing and pin configuration

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