Surgical treatment of pediatric supracondylar humerus fracture could be safely performed by general orthopedists.

PURPOSE

Displaced pediatric supracondylar humerus fracture (SCHF) requires a reduction and instrumentation. The trend is to send the cases to a fellowship-trained pediatric orthopedist. This study reviewed the outcomes and complications of SCHF surgically managed by orthopedic surgeons with different backgrounds of subspecialty training.

METHODS

The medical records of 87 children (87 elbows) with an average age of 5.9 ± 3.1 (range 1.3-14.1) years with SCHF Gartland 2 and 3 who underwent operative fixation were reviewed. The demographics data and operative details were obtained. Radiographically, the Baumann and humerocapitella angles were measured. The lateral rotational percentage of Gordon was calculated. The Griffet index 1 and 2 were retrieved. The parameters were compared among groups of surgeons with a pediatric fellowship-trained background and surgeons with other subspecialty training. A univariate analysis was calculated for the risk of postoperative complications.

RESULTS

The demographics data were comparable between the two groups. Children who were treated by non-pediatric fellowship-trained orthopedists showed higher but not significant degrees of postoperative Baumann angles; however, the proportion of children with an acceptable range of Baumann angle were similar. The overall complications rate was 17.5% and comparable between the two groups. Only SCHF Gartland 3 was associated with complications (P = 0.01).

CONCLUSIONS

Pediatric SCHF could be efficiently managed by a general orthopedic surgeon because the radiographic outcomes and complications were comparable to pediatric fellowship-trained orthopedists. Extra precautions need to be exercised in SCHF Gartland type 3 because the chance of complications is higher among these types of injuries.

LEVEL OF EVIDENCE

Level III.