Outcome of Pediatric Comminuted Open Supracondylar Humerus Fracture

Abstract

Abstract Introduction: Supracondylar humerus fracture is the most common fracture around the elbow in children. Closed fractures of the supracondylar humerus are ostensibly more common compared to open injuries. Though closed reduction and pinning are often feasible for Gustilo Anderson Grade 1 open fractures, surgical debridement followed by open reduction and pinning or JESS fixator application may often be required in open supracondylar humerus fractures with higher Gustilo Anderson grades. Materials and Methods: A retrospective study was conducted from 2018 to 2022 on children with open comminuted supracondylar humerus fractures. Open fractures were classified as per Gustilo Anderson’s classification, and fracture patterns were described as per modified Gartland’s and AO classifications. All patients were treated with closed or open-assisted reduction and fixation. Children were reviewed at the third/fourth and eighth weeks and later at 6 months and one year for the cosmetic and functional outcome assessment by Flynn criteria. Orthogonal elbow radiographs were obtained to assess radiographic parameters at each visit, including the final follow-up. Result: Six children with a mean age of 8.3 years (3–12 years) were treated during the study period. One child had grade 3A, two had grade 2, and three had grade 1 open fractures, according to Gustilo Anderson’s classification. The mean duration from injury to presentation was 36.3 h. The mean time from presentation to surgery was 3.3 h (1–5 h). The mean follow-up period was 9.6 months (6–12 months). Four children had excellent outcomes, whereas one child each had fair and poor results according to Flynn’s functional outcome criteria. Conclusion: Children with comminuted open supracondylar humerus fractures with an unusual mechanism of injury and presenting early since injury had better functional outcomes on follow-up as compared to children presenting late, with associated complications undergoing the same.