An inconvenient truth: treatment of displaced paediatric supracondylar humeral fractures.
AffiliationDepartment of Orthopaedic Surgery, Waterford Regional Hospital, Dunmore road, Waterford, Ireland.
MeSHAnalysis of Variance
Fracture Fixation, Internal
Injury Severity Score
Length of Stay
Range of Motion, Articular
Recovery of Function
MetadataShow full item record
CitationAn inconvenient truth: treatment of displaced paediatric supracondylar humeral fractures. 2012, 10 (3):143-7 Surgeon
JournalThe surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
AbstractThe need for emergent management of displaced paediatric supracondylar humeral fractures is being questioned in the literature. Open reduction rates of up to 46% have been reported in the non-emergent management of these injuries. At our institution these fractures are managed as operative emergencies by senior personnel. To examine the ongoing need for this policy we reviewed our results. All patients managed over a five year period with Gartland type IIB or III paeditric supracondylar humeral fractures were identified and a comprehensive chart and radiographic review undertaken. The mean time from injury to fracture reduction and stabilization was 6.6 h. Consultants performed or supervised 90% of cases. Open reduction was necessary in 5% of cases. Complications included a perioperative nerve injury rate of 6% and a superficial pin site infection rate of 3%. This study suggests that, despite the challenge to trauma on-call rostering, the emergency management of these injuries is advantageous to patients in units of our size. Based on the data presented here we continue our practice of emergent management. We suggest that units of a similar size to our own would show a benefit from an analogous policy albeit an inconvenient truth.