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Open Supracondylar Humerus Fractures in Children
Tommy Pan1, Matthew R Widner1, Michael M Chau2
1Department of Orthopaedics and Rehabilitation, Penn State College of Medicine, Hershey, USA.
Open supracondylar humerus fractures in children are rare but serious. Urgent treatment with antibiotics, irrigation and debridement, and pinning yields excellent outcomes without complications.
Area of Science:
- Pediatric Orthopedics
- Trauma Surgery
Background:
- Supracondylar humerus (SCH) fractures are the most common elbow fractures in children.
- Open SCH fractures, though rare, carry significant risks including infection and neurovascular injury.
Purpose of the Study:
- To evaluate the treatment and outcomes of pediatric open SCH fractures.
Main Methods:
- Retrospective review of four pediatric patients with open SCH fractures (2008-2015).
- Analysis of treatment including intravenous antibiotics, irrigation and debridement (I&D), and closed reduction and percutaneous pinning (CRPP) with a medial pin.
- Outcomes assessed based on infection, neurovascular status, and functional recovery.
Main Results:
- No infections, neurovascular deficits, or compartment syndromes occurred in the four patients.
- All patients achieved excellent outcomes according to Flynn criteria with bony union by six weeks.
- No loss of reduction or ulnar nerve injury was observed.
Conclusions:
- Open SCH fractures in children require prompt management with antibiotics, I&D, and CRPP.
- The use of a medial pin in CRPP is recommended for stability in these injuries.
- Urgent intervention leads to excellent outcomes and prevents complications.
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