Outcomes of Pediatric Supracondylar Fracture Treated Within or After 24 Hours of Injury

Abstract

Background: Supracondylar elbow fracture (SCEF) is the most common fracture in the elbow region in children. Considering its high prevalence and the potential complications, proper management of this condition is paramount.
Objectives: The aim of this paper is to report the results of an assessment of timing for SCEF surgery and the prevalence of related complications.
Patients and Methods: We retrospectively reviewed the outcomes of patients with SCEF who presented to our tertiary care pediatric emergency department between September 2013 and March 2014. We reviewed their charts to assess several clinical parameters, including age, sex, Gartland classification of SCEF, weight, comorbidities, treatment intervention, physiotherapy, and the extremity involved. The children were divided into two treatment groups: 1) early, if treated within 24 hours after injury; and 2) late, if treated 24 hours or later after injury. Perioperative complications and short-term outcomes were compared between the two groups.
Results: Of the 24 patients reviewed, 16 were in the early group and 8 were in the late group. There were no significant differences between the two groups regarding perioperative complications such as pin tract infection, iatrogenic nerve injury, compartment syndrome, or range of motion after six months of follow-up (P value = 0.227).
Conclusions: A delay in surgery for more than 24 hours after injury does not influence the perioperative complications and clinical results for displaced supracondylar humeral fractures in children. We conclude that night operations can be avoided.