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Outcomes of Pediatric Supracondylar Humerus Fracture Fixation in a District Hospital in Saudi Arabia: A Retrospective
Mansour M Aldhilan1, Azeez O Tella2
1Orthopedic Surgery, Al Rass General Hospital, Ministry of Health, Al Rass, SAU.
Insights
Closed reduction and percutaneous pinning effectively treats pediatric supracondylar humerus fractures. This method, even in district hospitals, yields good outcomes with few complications, confirming its status as the gold standard.
Area of Science:
- Orthopedic Surgery
- Pediatric Traumatology
Background:
- Supracondylar humerus fractures are common in children.
- Treatment of these fractures can be complex.
- Closed reduction and percutaneous pinning is the standard for displaced fractures.
Purpose of the Study:
- To review the management of pediatric supracondylar humerus fractures.
- To document the experience at a district general hospital.
- To evaluate clinical outcomes and complications.
Main Methods:
- Retrospective analysis of 36 pediatric patients' medical records.
- Data included demographics, injury details, fracture classification (modified Gartland), surgical approach, and outcomes.
- Follow-up assessed clinical results and complications.
Main Results:
- Most fractures were extension-type (97.2%).
- 91.7% of patients underwent closed reduction and percutaneous pinning.
- Overall complication rate was 11.2%, with superficial infection (5.6%) and ulnar nerve palsy (2.8%) being most common.
Conclusions:
- Closed reduction and percutaneous pinning is the gold standard for displaced supracondylar humerus fractures in children.
- Satisfactory outcomes were achieved in all patients, consistent with literature.
- The procedure offers an acceptable complication profile even in resource-limited settings.
Abstract:
Background Supracondylar humerus fractures are among the most common pediatric fractures, and treatment can be challenging. Closed reduction and percutaneous pinning is the recommended treatment for displaced fractures. This study aimed to review the management of supracondylar humerus fractures at a district general hospital and to document our experience. Materials and methods We conducted a retrospective analysis of electronic medical records of pediatric patients who underwent surgical treatment of supracondylar humerus fractures treated over a 30-month period. Data collected included demographics, mechanism of injury, fracture type, modified Gartland classification, surgical management, clinical outcomes, and complications. Results A total of 36 patients met the inclusion criteria. The mean age was 5.2 ± 2.6 years (range 1-12 years), with a male-to-female ratio of 1.6:1. Extension-type injuries were observed in 35 patients (97.2%) and flexion-type in one patient (2.8%). According to the modified Gartland classification, extension-type fractures were distributed as follows: type II (34.3%), type III (60%), and type IV (5.7%). Most patients (91.7%) were treated with closed reduction and percutaneous pinning. The overall complication rate was 11.2%, with superficial surgical site infection being the most common (5.6%). One patient (2.8%) developed postoperative ulnar nerve palsy, attributed to medial pin placement. Based on Flynn's criteria, all patients achieved satisfactory outcomes at the final follow-up. Conclusion Our findings are consistent with those reported in the literature. Despite limited resources, closed reduction and percutaneous pinning remain the gold standard for managing displaced supracondylar humerus fractures, yielding satisfactory clinical outcomes and an acceptable complication profile.
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