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Sex-based differences in pediatric supracondylar humerus fractures
Christa L LiBrizzi1, Walter Klyce, Alvaro Ibaseta
1Division of Pediatric Surgery, Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Medicine
|May 24, 2020
Summary
Pediatric supracondylar humerus (SCH) fractures occur equally in boys and girls, challenging previous beliefs. Girls sustain these fractures at a younger age, but sex does not influence fracture patterns or complications.
Area of Science:
- Orthopedic Surgery
- Pediatric Traumatology
- Pediatric Orthopedics
Background:
- Supracondylar humerus (SCH) fractures are common pediatric injuries.
- Previous literature suggests SCH fractures are more prevalent in boys.
- Limited data exists on sex-associated differences in fracture patterns and complications.
Purpose of the Study:
- To compare the incidence, injury mechanisms, fracture subtypes, associated neurologic injuries, and treatment types of pediatric SCH fractures between sexes.
- To investigate potential sex-based disparities in the presentation and outcomes of SCH fractures.
Main Methods:
- Retrospective review of 1231 pediatric SCH fractures treated between 2008 and 2017.
- Analysis of demographic characteristics, injury mechanisms (high-energy vs. low-energy), fracture subtypes (Gartland classification), neurologic injuries, and treatment (operative vs. nonoperative).
- Statistical analysis included binomial, chi-squared, and Student's t tests, with logistic regression to assess associations between sex, age, and injury mechanism.
Main Results:
- SCH fractures were equally distributed between girls (52%) and boys (48%) in the study sample, with no significant change over time.
- Girls sustained SCH fractures at a significantly younger mean age (5.5 years) compared to boys (6.1 years).
- No significant sex-associated differences were found in injury mechanism, Gartland fracture subtypes, incidence of neurologic injury (9.5% overall), or treatment type.
Conclusions:
- Contrary to prior perceptions, pediatric SCH fractures occur with equal frequency in both sexes.
- Girls tend to experience SCH fractures at a younger age than boys.
- Patient sex is not a significant factor influencing fracture patterns, injury mechanisms, neurologic complications, or treatment choices for pediatric SCH fractures.
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