Fracture Patterns, Skeletal Age, and Outcomes in Adolescent Supracondylar Humerus Fractures Treated With Open...

Area of Science:

• Orthopedic surgery
• Pediatric orthopedics
• Traumatology

Background:

• Supracondylar humerus fractures (SCHF) in adolescents nearing skeletal maturity are uncommon.
• Literature on managing complex SCHFs with open reduction internal fixation (ORIF) in this age group is limited.

Purpose of the Study:

• To retrospectively evaluate the outcomes of SCHFs treated with ORIF at a single tertiary pediatric center.
• To compare management strategies and outcomes for T-type (intercondylar extension) versus extraarticular SCHFs (eSCHF) in adolescents.

Main Methods:

• Retrospective cohort study of patients aged 7-18 treated with ORIF for T-type or eSCHF between 2015-2024.
• Exclusion criteria included percutaneous pinning alone or prior elbow fractures.
• Demographics, skeletal age, injury mechanism, fracture type, fixation strategy, union, range of motion (ROM), and complications were analyzed.

Main Results:

• Twenty-eight adolescents (mean age 12.7 years) were included.
• T-type fractures occurred in older, more skeletally mature patients and favored plate/screw fixation.
• All fractures achieved union (mean 11 weeks); T-type fractures had shorter immobilization but more stiffness at 3 months.
• High complication rate (64%), mainly due to hardware pain (32%).

Conclusions:

• T-type SCHFs in skeletally mature adolescents are associated with slower ROM recovery.
• Fixation strategy correlated with fracture type, but clinical outcomes did not significantly differ between fixation methods.
• Prospective studies are needed to optimize adolescent SCHF treatment.