Citation

Kuoppala E, Parviainen R, Pokka T, Sirviö M, Serlo W, Sinikumpu JJ. Acta Orthop. 2016; 87(4): 406-411.

Affiliation

a Department of Children and Adolescents, Pediatric Surgery and Orthopedics , Oulu University Hospital, Medical Research Center Oulu, Oulu University, PEDEGO Research Group , Finland.

Copyright

(Copyright © 2016, Informa - Taylor and Francis Group)

DOI

10.1080/17453674.2016.1176825

PMID

27168001

Abstract

Background and purpose - Supracondylar humerus fractures are the most common type of elbow fracture in children. A small proportion of them are flexion-type fractures. We analyzed their current incidence, injury history, clinical and radiographic findings, treatment, and outcomes. Patients and methods - We performed a population-based study, including all children <16 years of age. Radiographs were re-analyzed to include only flexion-type supracondylar fractures. Medical records were reviewed and outcomes were evaluated at a mean of 9 years after the injury. In addition, we performed a systematic literature review of all papers published on the topic since 1990 and compared the results with the findings of the current study.

RESULTS - During the study period, the rate of flexion-type fractures was 1.2% (7 out of 606 supracondylar humeral fractures). The mean annual incidence was 0.8 per 105. 4 fractures were multidirectionally unstable, according to the Gartland-Wilkins classification. All but 1 were operatively treated. Reduced range of motion, changed carrying angle, and ulnar nerve irritation were the most frequent short-term complications. Finally, in the long-term follow-up, mean carrying angle was 50% more in injured elbows (21°) than in uninjured elbows (14°). 4 patients of the 7 achieved a satisfactory long-term outcome according to Flynn's criteria. Interpretation - Supracondylar humeral flexion-type fractures are rare. They are usually severe injuries, often resulting in short-term and long-term complications regardless of the original surgical fixation used.

Language: en