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Surgical treatment outcome for open supracondylar humerus fractures in children
Emin Ozkul1, Mehmet Gem2, Hüseyin Arslan2
1Department of Orthopaedics and Traumatology, Dicle University Medical Faculty, Diyarbakir, Turkey. eminozkul21@hotmail.com
Insights
Open supracondylar humerus fractures in children, though often accompanied by nerve and vascular injuries, show excellent long-term outcomes. Functional results in pediatric patients are comparable to closed fractures.
Area of Science:
- Pediatric Orthopedics
- Traumatology
- Skeletal Injuries
Background:
- Open supracondylar humerus fractures in children are less studied than closed fractures.
- Limited data exists on the long-term prognosis of these injuries.
Purpose of the Study:
- To evaluate the early and late outcomes of pediatric open supracondylar humerus fractures.
- To assess functional recovery and potential complications.
Main Methods:
- Retrospective analysis of 26 pediatric patients with open supracondylar humerus fractures.
- Classification using the Gustilo-Anderson system.
- Functional outcomes assessed using Flynn criteria.
Main Results:
- 18 fractures were type 1, 8 were type 2 (Gustilo-Anderson).
- 34% had nerve injury, 15% had absent distal pulses.
- Excellent outcomes (Flynn criteria) in 23 patients; successful in 3.
- Nerve function recovery in 3-6 months for affected patients.
- Mean union time was 6 weeks.
Conclusions:
- Pediatric open supracondylar humerus fractures can have excellent long-term functional and radiological outcomes.
- Vascular and nerve injuries are common but do not preclude good results.
- Outcomes are comparable to those seen in closed fractures.
Abstract:
Although numerous studies have been conducted on supracondylar humerus fractures in children, there is only a limited number of studies regarding the outcome of open fractures. In this study, the early and late outcome of open supracondylar humerus fractures in children were evaluated. The outcome in 26 children (19 males, 7 females) treated for open supracondylar humerus fractures was evaluated retrospectively. The mean age was 73 years (range: 4 to 14) and the mean follow-up period was 43 years (range: 2-8). According to the Gustilo-Anderson classification, 18 patients (69%) had type 1 and 8 patients (31%) type 2 open fractures. Nine patients (34%) presented with a nerve injury. Distal pulses could not be detected in four patients (15%). Functional outcomes were evaluated according to the scoring criteria by Flynn et al. Pin tract infection developed in one patient (3%). Artery repair via an anterior approach was performed in one patient. In nine patients with neurological symptoms, nerve functions were restored within three to six months. The mean union time was six weeks (5-8 weeks). According to the scoring criteria by Flynn et al, an excellent outcome was achieved in 23 patients, and a successful outcome in 3 patients. According to these findings, although vascular and nerve injuries frequently accompany open supracondylar humerus fractures in children, the late radiological and functional outcome was as good as in closed fractures.
