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Displaced Supracondylar Humerus Fractures in Toddlers

Striano, Brendan M ; De Mattos, Camila LU orcid ; Ramski, David E ; Flynn, Kelly R and Horn, B David (2020) In Orthopedics 43(5). p.421-424
Abstract

Gartland type III fracture is the most troublesome type of supracondylar humerus fracture. These injuries most often occur in school age children, but they are seen in pediatric patients of all ages. The goal of this study was to analyze toddlers with Gartland type III fractures to identify clinically significant differences compared with older children. A retrospective cohort study was conducted with 94 toddlers (<3 years) and 378 older children (3 to 12 years). Factors including demographics, mechanism of injury, additional injuries, location of trauma, pin configuration, postoperative complications, follow-up time, and compliance with the treatment plan were collected and compared. The study included 94 toddlers (59% girls,... (More)

Gartland type III fracture is the most troublesome type of supracondylar humerus fracture. These injuries most often occur in school age children, but they are seen in pediatric patients of all ages. The goal of this study was to analyze toddlers with Gartland type III fractures to identify clinically significant differences compared with older children. A retrospective cohort study was conducted with 94 toddlers (<3 years) and 378 older children (3 to 12 years). Factors including demographics, mechanism of injury, additional injuries, location of trauma, pin configuration, postoperative complications, follow-up time, and compliance with the treatment plan were collected and compared. The study included 94 toddlers (59% girls, 2.11±0.64 years) and 378 older children (48% girls, 6.32±1.89 years), chosen at random, who were treated between 2000 and 2015. Among toddlers, fractures were more likely to occur at home (P<.001) and to be the result of suspected nonaccidental trauma (P<.001). Older children had more additional injuries (P<.001), but were no more likely to have an open fracture (P=.59) or a flexion-type fracture (P=.42). Older children were more likely to undergo open reduction (P=.03), whereas toddlers were more likely to be treated with a medial pin (P<.001). Toddlers experienced more cubitus varus (P<.001) and loss of reduction (P=.02). No difference was found in length of follow-up (P=.83) or compliance with the treatment plan (P=.11). This study provides novel insights into clinical differences between toddlers and older children with Gartland type III fractures. Knowledge of these differences can facilitate the delivery of targeted, age-specific care for patients with type III supracondylar humerus fractures. [Orthopedics. 2020;43(5);e421-e424.].

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Bone Nails, Child, Child, Preschool, Female, Humans, Humeral Fractures/surgery, Infant, Male, Open Fracture Reduction, Range of Motion, Articular, Retrospective Studies
in
Orthopedics
volume
43
issue
5
pages
421 - 424
publisher
Slack Inc
external identifiers
  • scopus:85091126999
  • pmid:32602923
ISSN
1938-2367
DOI
10.3928/01477447-20200619-13
language
English
LU publication?
yes
additional info
Copyright 2020, SLACK Incorporated.
id
86b72f4a-49a3-4956-8433-d04d16a3a14c
date added to LUP
2023-11-16 09:39:40
date last changed
2024-03-31 15:52:24
@article{86b72f4a-49a3-4956-8433-d04d16a3a14c,
  abstract     = {{<p>Gartland type III fracture is the most troublesome type of supracondylar humerus fracture. These injuries most often occur in school age children, but they are seen in pediatric patients of all ages. The goal of this study was to analyze toddlers with Gartland type III fractures to identify clinically significant differences compared with older children. A retrospective cohort study was conducted with 94 toddlers (&lt;3 years) and 378 older children (3 to 12 years). Factors including demographics, mechanism of injury, additional injuries, location of trauma, pin configuration, postoperative complications, follow-up time, and compliance with the treatment plan were collected and compared. The study included 94 toddlers (59% girls, 2.11±0.64 years) and 378 older children (48% girls, 6.32±1.89 years), chosen at random, who were treated between 2000 and 2015. Among toddlers, fractures were more likely to occur at home (P&lt;.001) and to be the result of suspected nonaccidental trauma (P&lt;.001). Older children had more additional injuries (P&lt;.001), but were no more likely to have an open fracture (P=.59) or a flexion-type fracture (P=.42). Older children were more likely to undergo open reduction (P=.03), whereas toddlers were more likely to be treated with a medial pin (P&lt;.001). Toddlers experienced more cubitus varus (P&lt;.001) and loss of reduction (P=.02). No difference was found in length of follow-up (P=.83) or compliance with the treatment plan (P=.11). This study provides novel insights into clinical differences between toddlers and older children with Gartland type III fractures. Knowledge of these differences can facilitate the delivery of targeted, age-specific care for patients with type III supracondylar humerus fractures. [Orthopedics. 2020;43(5);e421-e424.].</p>}},
  author       = {{Striano, Brendan M and De Mattos, Camila and Ramski, David E and Flynn, Kelly R and Horn, B David}},
  issn         = {{1938-2367}},
  keywords     = {{Bone Nails; Child; Child, Preschool; Female; Humans; Humeral Fractures/surgery; Infant; Male; Open Fracture Reduction; Range of Motion, Articular; Retrospective Studies}},
  language     = {{eng}},
  month        = {{09}},
  number       = {{5}},
  pages        = {{421--424}},
  publisher    = {{Slack Inc}},
  series       = {{Orthopedics}},
  title        = {{Displaced Supracondylar Humerus Fractures in Toddlers}},
  url          = {{http://dx.doi.org/10.3928/01477447-20200619-13}},
  doi          = {{10.3928/01477447-20200619-13}},
  volume       = {{43}},
  year         = {{2020}},
}