The effect of surgical timing on the perioperative complications of treatment of supracondylar humeral fractures in children.
BACKGROUND
The purpose of this study was to evaluate the perioperative complication rates associated with early surgical treatment (eight hours or less following injury) and delayed surgical treatment (more than eight hours following injury) of displaced supracondylar humeral fractures in children.


METHODS
Fifty-two patients had early surgical treatment and 146 patients had delayed surgical treatment of a displaced supracondylar humeral fracture. The perioperative complication rates of the two groups were compared with the use of bivariate and multivariate statistical methods.


RESULTS
There was no significant difference between the two groups with respect to the need for conversion to formal open reduction and internal fixation (p = 0.56), pin-track infection (p = 0.12), or iatrogenic nerve injury (p = 0.72). No compartment syndromes occurred in either group. Power analysis revealed that our study had an 86% power to detect a 20% difference between the two groups if one existed.


CONCLUSIONS
We were unable to identify any significant difference, with regard to perioperative complication rates, between early and delayed treatment of displaced supracondylar humeral fractures. Within the parameters outlined in our study, we think that the timing of surgical intervention can be either early or delayed as deemed appropriate by the surgeon.
Division of Pediatric Orthopaedic Surgery, Children's Hospital Medical Center, University of Cincinnati College of Medicine, Ohio 45229-3039, USA.
C T
CT
Mehlman
W M
WM
Strub
D R
DR
Roy
E J
EJ
Wall
A H
AH
Crawford
D000293:Adolescent; D002648:Child; D004632:Emergency Medical Services; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D008297:Male; D013997:Time Factors