title: An evaluation of supracondylar humerus fractures: is there a correlation between postponing treatment and the need for open surgical intervention?
abstract: OBJECTIVE
  The goal of this study was to evaluate the treatment and recovery of patients treated for Gartland type III supracondylar humerus fractures in order to determine if postponing treatment leads to a higher rate of open surgical treatment or complications.
  
  
  METHODS
  A retrospective study was conducted examining the medical records of children with Gartland type III supracondylar humerus fractures at our institution for a two-year period. The patients included in the study were treated with closed reduction and percutaneous pinning (CRPP) or open reduction and internal fixation (ORIF).
  
  
  RESULTS
  After exclusions, 134 patients were included in the study, with an average age of 5.6 years. The patients were grouped according to whether their treatment was postponed (39.6 %) or immediate (60.4 %). The majority of all patients were treated using CRPP: 46 (86.8 %) of the postponed patients and 75 (92.6 %) of the immediate patients. Very few postsurgical complications occurred in the patients; there was only one (1.6 %) case of iatrogenic nerve injury in a postponed patient as well as four (3.8 %) cases of loss of carrying angle: one (2.3 %) in postponed patients and three (4.8 %) in immediate patients.
  
  
  CONCLUSIONS
  Postponing treatment of type III supracondylar humerus fractures in children did not lead to an increase in open surgical treatment; nor did it lead to an increase in complications.
authors.affiliation: Department of Orthopaedics, Children's Hospital of Michigan, Detroit, MI USA.
authors.forename: John M
authors.initials: JM
authors.lastname: Kronner
authors.affiliation: Department of Orthopaedics, Children's Hospital of Michigan, Detroit, MI USA.
authors.forename: Julie E
authors.initials: JE
authors.lastname: Legakis
authors.affiliation: Department of Orthopaedics, Children's Hospital of Michigan, Detroit, MI USA.
authors.forename: Natalia
authors.initials: N
authors.lastname: Kovacevic
authors.affiliation: Department of Clinical Pharmacology, Children's Hospital of Michigan, Detroit, MI USA.
authors.forename: Ronald L
authors.initials: RL
authors.lastname: Thomas
authors.affiliation: Department of Orthopaedics, Children's Hospital of Michigan, Detroit, MI USA.
authors.forename: Richard A K
authors.initials: RA
authors.lastname: Reynolds
authors.affiliation: Department of Orthopaedics, Children's Hospital of Michigan, Detroit, MI USA.
authors.forename: Eric T
authors.initials: ET
authors.lastname: Jones
keywords: Closed reduction percutaneous pinning; Delayed fracture treatment; Pediatric; Supracondylar humerus fracture