Operative Treatment of Pediatric Supracondylar Humerus Fractures Using Mini C-Arm Fluoroscopy

Area of Science:

• Orthopedic surgery
• Pediatric orthopedics
• Medical imaging technology

Background:

• Supracondylar humerus (SCH) fractures are common in children, often requiring surgical intervention.
• Displaced SCH fractures are typically treated with reduction and percutaneous pinning using conventional C-arm (CCA) fluoroscopy.
• Mini C-arm (MCA) fluoroscopy offers potential benefits like reduced radiation exposure for upper extremity procedures.

Purpose of the Study:

• To investigate the utility and safety of MCA in the operative treatment of pediatric SCH fractures.
• To compare outcomes and complication rates of MCA versus CCA for SCH fracture fixation.
• To assess fluoroscopy usage patterns with MCA based on fracture characteristics.

Main Methods:

• Retrospective review of 171 pediatric patients undergoing SCH fracture fixation with MCA (2020-2022).
• Collection of demographic, surgical, radiographic, and clinical outcome data.
• Analysis of fluoroscopy use, complication rates, and reoperation rates.

Main Results:

• The study included 171 patients with an average age of 5.5 years; 55% had Gartland type 3/4 fractures.
• Median fluoroscopy time was 113 seconds with 61 images; usage increased with fracture severity and pin number.
• Overall complication rate was 2%, with only one reoperation (0.6%).

Conclusions:

• MCA fluoroscopy is associated with low complication rates for pediatric SCH fractures, similar to CCA.
• While fluoroscopy use may be higher with MCA, it doesn't necessarily increase radiation exposure.
• MCA may offer advantages over CCA for SCH fracture treatment in certain clinical settings.