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The Effect of Fracture Patterns, Pinning Configuration, Surgeon Experience and Subspecialty on Short-Term
Andrea Vescio1, Giovanni Carlisi2, Vincenzo Roberto Macrì1
1Departiment of Orthopaedic and Trauma Surgery, Azienda Ospedaliera Pugliese Ciaccio, 88100 Catanzaro, Italy.
Insights
Surgeon experience and pinning technique do not impact short-term outcomes for pediatric supracondylar humerus fractures (SCHFs) treated with closed reduction and percutaneous pinning (CRPP). This study found no significant differences in radiological results based on these factors.
Area of Science:
- Pediatric Orthopedics
- Surgical Outcomes
- Fracture Management
Background:
- Supracondylar humerus fractures (SCHFs) are common in children.
- Closed reduction and percutaneous pinning (CRPP) is the standard treatment.
- Optimal CRPP techniques remain under debate.
Purpose of the Study:
- To evaluate the influence of surgeon experience and pin configuration on short-term radiological outcomes in pediatric SCHFs treated with CRPP.
- To analyze the impact of fracture patterns and surgeon subspecialty on CRPP outcomes.
Main Methods:
- Retrospective analysis of 44 pediatric patients (<14 years) with displaced SCHFs treated in the prone position.
- Subgroup analysis based on fracture type, pin configuration, and surgeon experience.
- Outcome measures included postoperative Baumann's angle (BA), Shaft-Condylar angle (SCA), surgical duration, radiation exposure, and follow-ups.
Main Results:
- No significant differences in postoperative BA or SCA were observed across subgroups.
- Surgical duration, radiation exposure, and follow-up frequency were similar among all patient groups.
- Mean postoperative BA was 74.8° ± 4.9°, and SCA was 37.7° ± 10.2°.
Conclusions:
- Short-term radiological outcomes for pediatric SCHFs treated with CRPP in the prone position are not influenced by fracture patterns or pinning configurations.
- Surgeon experience and subspecialty do not appear to affect these short-term outcomes.
Background:
The most common treatment modality for supracondylar humerus fractures (SCHFs) in children is closed reduction and percutaneous pinning (CRPP). Nonetheless, debate persists regarding the optimal technique used. Therefore, the purpose of our study was to investigate the impact of surgeon experience, surgeon subspecialty and pin configuration on short-term radiological outcomes following CRPP of displaced SCHFs.
Methods:
Patients less than 14 years of age who underwent CRPP for displaced SCHFs in the prone position between January 2018 and December 2022 were analyzed. Patients were separated into subgroups based on fracture type (low vs. high sagittal), pin configuration (lateral, cross, other), number and configuration of K-wires and first operator surgical experience. The following outcome measurements were collected: postoperative Baumann angle (BA), Shaft-Condylar angle (SCA), surgical duration (SD), duration of radiation exposure (DRE) and number of clinical and radiological follow-ups (FU).
Results:
A total of 44 patients with a mean age of 6 ± 2.5 years were included in the final analysis. The mean post-operative BA and SCA were 74.8° ± 4.9° and 37.7° ± 10.2°, respectively. No significant differences were found in the post-operative Baumann's angle or SCA among the subgroups. Regarding secondary outcomes, no differences were found among each subgroup regarding SD, DRE and FUs.
Conclusion:
Short-term radiological outcomes following the treatment of SCHFs treated in the prone position are not affected by fracture patterns and pinning configuration, regardless of the surgeon's years of experience or subspecialty.
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