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Complications associated with Pediatric Supracondylar Humeral Fractures
Ernesto Del Valle-Hernández1, Pablo A Marrero-Barrera1, David Beaton1
1Department of Orthopaedic Surgery, University of Puerto Rico School of Medicine, San Juan, PR.
Insights
Pediatric supracondylar fractures in Puerto Rico show similar epidemiology and complication rates to national data. However, specific fracture types like posteromedial and posterolateral displacement warrant further investigation.
Area of Science:
- Orthopedic surgery
- Pediatric trauma
- Epidemiology
Background:
- Supracondylar fractures are common in children.
- Understanding local epidemiology and complication rates is crucial for effective management.
- Previous studies have established national benchmarks for these fractures.
Purpose of the Study:
- To determine the epidemiology, fracture rate, and complication profile of pediatric supracondylar fractures in Puerto Rico.
- To compare local findings with national rates reported in existing literature.
- To identify any unique characteristics of these fractures within the studied population.
Main Methods:
- A retrospective record review of 330 pediatric patients treated for supracondylar fractures at the University Pediatric Hospital of Puerto Rico Medical Center.
- Inclusion criteria: patients treated between January 2008 and January 2011 with at least a 1-year follow-up.
- Data collected included fracture type, treatment (open reduction internal fixation or closed reduction percutaneous pinning), and complications. Statistical significance was set at p<0.05.
Main Results:
- The study included 330 patients (62% male, 38% female) with an average age of 5.49 years.
- Extension-type fractures (98.2%) were predominant over flexion-type (1.8%).
- Neurological complication rates were 10% overall, with no significant difference between posteromedial (13.5%) and posterolateral (11.8%) displacement.
Conclusions:
- The epidemiological data and complication rates for pediatric supracondylar fractures in Puerto Rico align with national literature.
- A significant difference was noted in the rates of posteromedial versus posterolateral supracondylar fractures, suggesting a need for further research.
- The findings affirm the adequacy of care and management provided by the institution for these fractures.
Objective:
To measure pediatric supracondylar fracture epidemiology, fracture rate, and complications in the island's pediatric population. The study aims to compare our results to the national rates reported in the literature.
Methods:
In this retrospective record review we examined 330 patients who underwent open reduction internal fixation or closed reduction percutaneous pinning in pediatric supracondylar fractures at the University Pediatric Hospital of Puerto Rico Medical Center (HOPU). The study evaluated patients from January 2008 to January 2011 that had completed at least a 1 year follow-up. Measurement of type of fracture, and complications were recorded. Statistical significance was set at a p-valuevalue<0.05.
Results:
Of the 330 patients, 206 (62%) were male and 127 (38%) were female. The average age was 5.49 years (± 2.43). The vast majority had extension-type fractures (98.2%) and 1.8% had flexion-type fractures. The neurological complication rates were 10% (33 patients). Neurologic complications after distal fragment displacement were 13.5% for posteromedial displacement versus 11.8% for posterolateral displacement, with a p-value of 0.71.
Conclusion:
Our results in terms of female-to-male ratio, fracture type and complications (e.g., infection, vascular and neurologic complications) were similar to those reported in the literature. Because significant differences in the rates of posteromedial and posterolateral supracondylar fractures were found, we recommend further research on this subject. Overall, both our findings regarding complications and our results are similar to what has been reported in the literature. We can therefore affirm that our institution provides adequate care and management for this kind of fracture.
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