Open supracondylar humerus fractures in children: Associated injuries and clinical outcomes
Abdulsamet Emet1,2, Grace Armet1, Connor Luck1
1Department of Orthopaedic Surgery, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA.
Insights
Open supracondylar humerus (SCH) fractures are rare pediatric injuries. Management involves surgical repair, with associated nerve and vascular damage requiring attention.
Area of Science:
- Pediatric Orthopedics
- Trauma Surgery
- Skeletal System Injuries
Background:
- Supracondylar humerus (SCH) fractures are common in children.
- Open SCH fractures are infrequent but present significant management challenges.
Purpose of the Study:
- To determine the incidence of open SCH fractures in pediatric patients.
- To analyze associated injuries and postoperative outcomes.
- To evaluate the management strategies for open SCH fractures.
Main Methods:
- Retrospective review of pediatric patients with open SCH fractures (2005-2025).
- Data collection included demographics, injury characteristics, surgical procedures, and outcomes.
- Statistical analysis was performed to identify significant factors (p < 0.05).
Main Results:
- Open SCH fractures occurred in 1.1% of all SCH fractures.
- Extension-type Gartland III fractures were most common (91.2%).
- Associated nerve injuries (20.6%) and vascular damage (5.9%) were noted; 26.5% required reoperation.
Conclusions:
- Open SCH fractures are rare but serious injuries in children.
- These fractures frequently involve nerve and vascular structures requiring surgical intervention.
- Outcomes highlight the need for careful management and monitoring for complications.
Purpose:
Supracondylar humerus (SCH) fractures are common, but they rarely present as open fractures. This study aimed to evaluate the incidence, associated injuries, and postoperative outcomes of open SCH fracture management in the pediatric population.
Methods:
Children with open SCH fractures treated at a single institution between January 2005 and January 2025 were included in this study. Electronic medical records were reviewed to collect demographic data, fracture characteristics, surgical details, and postoperative outcomes. All patients underwent wound irrigation and debridement, open-assisted reduction, and K-wire fixation under general anesthesia. Postoperative care included immobilization, follow-up for fracture healing and range of motion (ROM), and selective physical therapy. Data were analyzed using standard statistical methods, with significance set at p < 0.05.
Results:
Among 3053 SCH fractures, 1.1% were open fractures (15 males, 19 females), with a mean age of 7.7 ± 2.4 years. The nondominant left arm was affected in 82.4% of cases, and the most common mechanism of injury was a fall from height (64.7%). Extension-type modified Gartland type III fractures were observed in 91.2% of patients, and Gustilo-Anderson type II was the most frequent open fracture classification (44.1%). Associated nerve injuries occurred in 20.6% of patients, and vascular repair was required in 5.9%. The mean time to pin removal was 4.7 ± 1 weeks. Overall, 26.5% of patients underwent reoperation, 26.5% experienced ≥10° reduction in flexion-extension ROM.
Conclusion:
Open SCH fractures are rare yet serious injuries, causing peripheral nerve and vascular damage that require surgical repair.
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