Displaced supracondylar humeral fractures: influence of delay of surgery on the incidence of open reduction, complications and outcome.

Schmid, Timo Georg Johannes; Joeris, Alexander; Slongo, Theddy; Ahmad, Sufian; Ziebarth, Kai (2015). Displaced supracondylar humeral fractures: influence of delay of surgery on the incidence of open reduction, complications and outcome. Archives of orthopaedic and trauma surgery, 135(7), pp. 963-969. Springer 10.1007/s00402-015-2248-0

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BACKGROUND Closed reduction and pinning is the accepted treatment choice for dislocated supracondylar humeral fractures in children (SCHF). Rates of open reduction, complications and outcome are reported to be dependent on delay of surgery. We investigated whether delay of surgery had influence on the incidence of open reduction, complications and outcome of surgical treatment of SCHFs in the authors' institution. METHODS Three hundred and forty-one children with 343 supracondylar humeral fractures (Gartland II: 144; Gartland III: 199) who underwent surgery between 2000 and 2009 were retrospectively analysed. The group consisted of 194 males and 149 females. The average age was 6.3 years. Mean follow-up was 6.2 months. Time interval between trauma and surgical intervention was determined using our institutional database. Clinical and radiographical data were collected for each group. Influence of delay of treatment on rates of open reduction, complications and outcome was calculated using logistic regression analysis. Furthermore, patients were grouped into 4 groups of delay (<6 h, n = 166; 6-12 h, n = 95; 12-24 h, n = 68; >24 h, n = 14) and the aforementioned variables were compared among these groups. RESULTS The incidence of open procedures in 343 supracondylar humeral fractures was 2.6 %. Complication rates were similar to the literature (10.8 %) primarily consisting of transient neurological impairments (9.0 %) which all were fully reversible by conservative treatment. Poor outcome was seen in 1.7 % of the patients. Delay of surgical treatment had no influence on rates of open surgery (p = 0.662), complications (p = 0.365) or poor outcome (p = 0.942). CONCLUSIONS In this retrospective study delay of treatment of SCHF did not have significant influence on the incidence of open reduction, complications, and outcome. Therefore, in SCHF with sufficient blood perfusion and nerve function, elective treatment is reasonable to avoid surgical interventions in the middle of the night which are stressful and wearing both for patients and for surgeons. LEVEL OF EVIDENCE III (retrospective comparative study).

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Surgery
04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery

UniBE Contributor:

Schmid, Timo Georg Johannes; Joeris, Alexander; Slongo, Theddy; Ahmad, Sufian and Ziebarth, Kai

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0936-8051

Publisher:

Springer

Language:

English

Submitter:

Christoph Steffen

Date Deposited:

01 Jun 2015 13:27

Last Modified:

19 Nov 2015 11:00

Publisher DOI:

10.1007/s00402-015-2248-0

PubMed ID:

26015155

BORIS DOI:

10.7892/boris.69216

URI:

https://boris.unibe.ch/id/eprint/69216

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