title: Gartland Type II Supracondylar Humerus Fractures, Their Operative Treatment and Lateral Pinning Are Increasing: A Population-Based Epidemiologic Study of Extension-Type Supracondylar Humerus Fractures in Children.
abstract: BackgroundSupracondylar humerus fractures are usual in children but their recent trends are unclear.Material and MethodsA population-based study was performed to determine the epidemiology of childhood supracondylar humerus fractures during the decade, 2000 to 2009, in a geographic area of Oulu, Finland. Altogether, 565 extension-type supracondylar humerus fractures were included. The fractures and their treatment were analyzed according to the Gartland classification.ResultsFracture incidence increased by 28%, from 50.9 to 65.2 per 100,000 during 2000 to 2009 (β = 1.03,p< 0.001). The increase was from 41.3 to 57.6 per 100,000 in girls (β = 1.9,p< 0.001). Trampoline-related fractures in particular increased in girls. Type II fractures increased twofold from 7.1 to 16.3 per 100,000 (β = 1.1,p< 0.001), whereas type I fractures decreased from 22.4 to 20.9 per 100,000 (β = -0.3,p= 0.026).Surgical treatment increased during the 10 years study period from 32.6 to 51.8% (p= 0.022); it was in particular due to increase of operative care of type II fractures (from 5.9% in 2000-2001 to 37.1% in 2008-2009;p= 0.011). Lateral pin fixation increased from nil to six (10.7%) (p< 0.001).ConclusionThe incidence and surgical stabilization of type II fractures in particular are increasing. There is a trend toward lateral pin fixation.
authors.affiliation: Department of Pediatric Surgery and Orthopedics, Oulu University Hospital, Oulu, Finland.|PEDEGO Research Group and MRC, Oulu University, Oulu, Finland.
authors.forename: Juha-Jaakko
authors.initials: JJ
authors.lastname: Sinikumpu
authors.affiliation: Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland.
authors.forename: Tytti
authors.initials: T
authors.lastname: Pokka
authors.affiliation: Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland.
authors.forename: Minna
authors.initials: M
authors.lastname: Sirviö
authors.affiliation: Department of Pediatric Surgery and Orthopedics, Oulu University Hospital, Oulu, Finland.
authors.forename: Willy
authors.initials: W
authors.lastname: Serlo
mesh_terms: D000293:Adolescent; D001858:Bone Nails; D002648:Child; D002675:Child, Preschool; D005260:Female; D005387:Finland / Q000453:epidemiology; D005592:Fracture Fixation / Q000295:instrumentation / Q000379:methods / Q000639:trends*; D006801:Humans; D006810:Humeral Fractures / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery*; D015994:Incidence; D016015:Logistic Models; D008297:Male; D010818:Practice Patterns, Physicians' / Q000639:trends*; D012189:Retrospective Studies; D012307:Risk Factors