Supracondylar humeral fractures in children: ten years' experience in a teaching hospital.
Although supracondylar fracture is a very common elbow injury in childhood, there is no consensus on the timing of surgery, approach for open reduction and positioning of fixation wires. We report our ten-year experience between 1993 and 2003 in 291 children. Most fractures (285; 98%) were extension injuries, mainly Gartland types II (73; 25%) and III (163; 56%). Six (2%) were open fractures and a neurovascular deficit was seen in 12 (4%) patients. Of the 236 children (81%) who required an operation, 181 (77%) were taken to theatre on the day of admission. Most (177; 75%) of the operations were performed by specialist registrars. Fixation was by crossed Kirschner wires in 158 of 186 (85%) patients and open reduction was necessary in 52 (22%). A post-operative neurological deficit was seen in nine patients (4%) and three (1%) required exploration of the ulnar nerve. Only 22 (4%) patients had a long-term deformity, nine (3%) from malreduction and three (1%) because of growth arrest, but corrective surgery for functional limitation was required in only three (1%) patients.
Mangwani
J
J
Colchester General Hospital, Turner Road, Colchester CO4 5JL, UK. jmangwani@hotmail.com
Nadarajah
R
R
Paterson
J M H
JM
D000058:Accidental Falls; D000293:Adolescent; D001864:Bone Wires; D002648:Child; D002675:Child, Preschool; D004551:Elbow Joint / Q000601:surgery; D005260:Female; D005592:Fracture Fixation / Q000379:methods; D006801:Humans; D006810:Humeral Fractures / Q000209:etiology / Q000601:surgery*; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000209:etiology; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D000092464:Elbow Injuries