title: Posterolaterally displaced and flexion-type supracondylar fractures are associated with a higher risk of open reduction.
abstract: To identify factors predictive of the risk of conversion from closed to open reduction. International Classification of Disease-9 codes were used to identify completely displaced pediatric supracondylar humerus fractures that were subjected to planned closed reduction and percutaneous pinning. Clinical and radiographic variables were retrospectively collected. Compared with posterior extension fractures, flexion (risk ratio: 34.1, 95% confidence interval: 8.1-143.6, P<0.0001) and posterolateral extension (risk ratio: 6.0, 95% confidence interval: 1.3-27.5, P=0.0221) fractures were significantly more likely to undergo conversion from closed to open reduction. The direction of displacement should be considered during the preoperative evaluation of supracondylar fractures.
authors.affiliation: aDepartment of Orthopaedic Surgery, Children's Hospital Colorado bDepartment of Orthopaedic Surgery, Musculoskeletal Research Center, Children's Hospital Colorado, Aurora cSchool of Medicine, University of Colorado Denver, Denver, Colorado, USA.
authors.forename: Eduardo N
authors.initials: EN
authors.lastname: Novais
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Carry
authors.forename: Bryan J
authors.initials: BJ
authors.lastname: Mark
authors.forename: Sayan
authors.initials: S
authors.lastname: De
authors.forename: Nancy H
authors.initials: NH
authors.lastname: Miller
mesh_terms: D001858:Bone Nails; D002648:Child; D002675:Child, Preschool; D005260:Female; D005593:Fracture Fixation, Internal; D005594:Fracture Fixation, Intramedullary; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D008297:Male; D000070799:Open Fracture Reduction; D011183:Postoperative Complications; D011184:Postoperative Period; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome