title: Factors associated with a failed closed reduction for supracondylar fractures in children.
abstract: OBJECTIVE
  The aim of this retrospective study is to analyze the risk factors causing the failure of closed reduction of children supracondylar fracture.
  
  
  METHODS
  The children with supracondylar humerus fractures who were treated in our hospital from February 2008 to February 2013, were recorded as well as their age, sex, BMI, injured side, mechanism of injury, associated injuries, fracture type, delay from injury to surgery. Mean comparisons or Chi(2) test were used for univariate analysis of the above factors, and then multivariate logistic regression analysis was used to analyse the possible risk factors, in order to elicit the risk factors associated with a failed closed reduction for supracondylar fractures in children.
  
  
  RESULTS
  Univariate analysis showed that BMI, fracture type, duration from injury to surgery, and mechanism of injury had statistically significant association with the failure of closed reduction for children supracondylar fracture (*P=0.021, 0.044, 0.000 and 0.037 respectively). Multivariate logistic regression analysis demonstrated that fracture type (P=0.027, OR=1.177), time from injury to surgery (P=0.022, OR=2.003), and mechanism of injury (P=0.044, OR=4.182) were independent risk factors of a failed closed reduction for paediatric supracondylar fractures.
  
  
  CONCLUSIONS
  Gartland type III supracondylar fractures, the peak period of soft tissue swelling and high-energy injury are significant risk factors to warrant open reduction. Treating surgeons should preoperatively carefully evaluate these risk factors and be prepared to treat these injuries accordingly.
  
  
  METHODS
  Level IV retrospective study.
authors.affiliation: Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical University, 109 Xueyuanxi Road, Wenzhou 325000, China.
authors.forename: L-J
authors.initials: LJ
authors.lastname: Sun
authors.affiliation: Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical University, 109 Xueyuanxi Road, Wenzhou 325000, China.
authors.forename: Z-P
authors.initials: ZP
authors.lastname: Wu
authors.affiliation: Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical University, 109 Xueyuanxi Road, Wenzhou 325000, China.
authors.forename: J
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical University, 109 Xueyuanxi Road, Wenzhou 325000, China.
authors.forename: N-F
authors.initials: NF
authors.lastname: Tian
authors.affiliation: Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical University, 109 Xueyuanxi Road, Wenzhou 325000, China.
authors.forename: X-B
authors.initials: XB
authors.lastname: Yu
authors.affiliation: Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical University, 109 Xueyuanxi Road, Wenzhou 325000, China.
authors.forename: W
authors.initials: W
authors.lastname: Hu
authors.affiliation: Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical University, 109 Xueyuanxi Road, Wenzhou 325000, China.
authors.forename: X-S
authors.initials: XS
authors.lastname: Guo
authors.affiliation: Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical University, 109 Xueyuanxi Road, Wenzhou 325000, China. Electronic address: chenhuayishi@163.com.
authors.forename: H
authors.initials: H
authors.lastname: Chen
mesh_terms: D002648:Child; D005260:Female; D005593:Fracture Fixation, Internal; D006801:Humans; D006810:Humeral Fractures / Q000145:classification / Q000209:etiology / Q000628:therapy*; D008297:Male; D008349:Manipulation, Orthopedic / Q000009:adverse effects*; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D061665:Time-to-Treatment; D017211:Treatment Failure
keywords: Children; Closed reduction; Risk factors; Supracondylar humerus fracture