Retrospective analysis of the determining factors for open reduction in pediatric humerus supracondylar fractures: Are factors such as time until operation and surgeon's experience effective?

Abstract

Aim: indications for open surgery are very limited in supracondylar humerus fractures (SCHFs). In our study, we aimed to examine whether the patient’s fracture type, waiting time of the patient before the operation, and the experience of the surgeon are effective on the treatment decision for open surgical method in our SCHF patients treated with open reduction. Methods: A group of pediatric patients treated with open reduction for SCHF between the years of 2010 and 2022 were examined for our study. Trauma mechanism, type of fracture, time until operation, neurovascular injuries and years of experience of the surgeons were retrospectively reviewed. Results: A total of 110 patients were included in the study. The mean age was 5.7 years. Nine patients were flexion-type SCHF. According to the Gartland classification, 19 patients were Type II and 82 patients were Type III. Ninety-four patients were operated in the first 24 hours, 16 patients were operated after 24 hours. There was no statistical correlation between the surgeons’ experience or time until operation and the type of the fractures. Patients with flexion type fractures were significantly older than the other patients. Conclusion: Extension Type III fractures are often require open surgery regardless of the surgeon's experience and waiting time for surgery. Regardless of the surgeon's years of experience and the type of the fracture, some fractures cannot be treated with closed reduction and require open reduction.