Related Experiment Video
Updated: May 6, 2026
Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
Published on: November 8, 2024
Daytime Versus After-hours Surgical Fixation of Pediatric Supracondylar Humeral Fractures: A Meta-analysis
Marc Boutros1, Guy Awad1, Jean-Pierre Saad1
1Université Saint-Joseph de Beyrouth, Beirut, Lebanon.
Insights
After-hours surgery for pediatric supracondylar humeral fractures (SCHFs) is as efficient as daytime procedures. While alignment complications were slightly higher after hours, overall outcomes for pediatric elbow fractures remain comparable.
Area of Science:
- Orthopedic Surgery
- Pediatric Orthopedics
- Trauma Surgery
Background:
- Pediatric supracondylar humeral fractures (SCHFs) are common elbow injuries requiring surgical fixation.
- After-hours surgery for SCHFs is often necessary but raises concerns about efficiency and outcomes.
Purpose of the Study:
- To compare perioperative efficiency, technical decision-making, and postoperative complications of pediatric SCHF surgery performed during daytime versus after-hours.
Main Methods:
- A systematic literature search identified seven comparative studies involving 913 pediatric patients.
- Outcomes analyzed included operative time, time to surgery, fixation techniques, and complications like pin migration, infection, and nerve injury.
Main Results:
- Operative time was similar, but time to surgery was shorter for after-hours procedures.
- Fixation techniques (medial pin, open reduction) showed no significant differences.
- Postoperative complications were comparable, except for a higher rate of alignment-related issues in the after-hours group.
Conclusions:
- Surgical timing (daytime vs. after-hours) for pediatric SCHFs generally yields comparable outcomes.
- Alignment complications warrant attention in after-hours cases, but timing alone may not dictate the overall result.
Background:
Pediatric supracondylar humeral fractures (SCHFs) are among the most common elbow injuries in children and frequently require operative fixation. Although after-hours surgery is often unavoidable due to emergency presentation patterns, many centers now reserve nighttime intervention for urgent indications such as vascular compromise. Concerns nevertheless persist regarding the potential impact of after-hours surgery on surgical efficiency, technical decision-making, and postoperative outcomes.
Methods:
A systematic search of PubMed, Scopus, the Cochrane Library, and Google Scholar was conducted from database inception through December 15, 2025. Comparative studies evaluating operative treatment of pediatric SCHFs performed during daytime working hours versus after-hours were included. Outcomes assessed comprised perioperative characteristics (operative time, time to surgery), intraoperative decision-making (medial pin fixation, open reduction), and postoperative complications (pin migration, alignment-related complications, infection, and iatrogenic postoperative nerve injury).
Results:
Seven studies encompassing 913 pediatric patients met the inclusion criteria. Operative time did not differ significantly between daytime and after-hours surgery ( P =0.11). Time to surgery was shorter in the after-hours group ( P <0.001). No significant differences were observed in rates of medial pin fixation ( P =0.70) or open reduction ( P =0.80). Postoperative complications, including pin migration, infection, and iatrogenic postoperative nerve injury, were comparable between groups, whereas alignment-related complications were more frequent in the after-hours group ( P =0.04).
Conclusions:
Operative fixation of pediatric SCHFs showed broadly comparable perioperative efficiency, technical outcomes, and complication rates when performed during daytime or after-hours, although alignment-related complications were more frequent in the after-hours group. These findings suggest that surgical timing alone may not be the primary determinant of outcome.
More Related Videos
12:25C-arm-Free Simultaneous OLIF51 and Percutaneous Pedicle Screw Fixation in a Single Lateral Position
Published on: September 16, 2022
04:41Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
Published on: June 6, 2025
