Complications and outcome of supracondylar fractures of the humerus in children
Abstract
Supracondylar fracture of the humerus is a common elbow injury in children.
The main objective of this retrospective study was to determine the epidemiological
characteristics, complications and outcome of supracondylar fractures of the humerus
in children as seen at Kenyatta National HospitaL
The study found out that supracondylar humeral fractures, had a peak incidence of
between four and seven years. Most patients were boys. Fall from height was the
commonest cause of injury. Displaced fractures (Gartland IlIa + IIlb) accounted for
the majority of these fractures (58.4%). Eighty four point four percent (84.4%) of
patients, with undisplaced fractures (Gartland I and II) treated conservatively had
good results, while 67.5 % of patients, with displaced fractures treated by open
reduction and internal fixation had good results.
Seven (7 of255) patients, sustained vascular injuries. These were noted to occur in
patients with high-energy fracture type (Gartland type IIIa). Compartment syndrome
occured in 1.2% (3 of 255) of the patients. All the three patients underwent
emergency fasciotomies and at follow-up, they were found to have good limb
function.
Twelve patients had neurological lesions. Ten of these recovered fully, without
operative intervention.
Long term complications included: - cubitus varus, cubitus valgus, elbow stiffuess
and myositis ossificans. The incidence of cubitus varus, a common angular deformity,
was found to be 12.6 %.
Key conclusions and recommendations were: - back slab-cast, collar and cuff is
adequate treatment for undisplaced fractures (Gartland I and II).
Closed reduction and percutaneous pininng method, is underutilized at Kenyatta
National Hospital and needs to be actively promoted.
Citation
Master of Medicine (surgery) at the University of Nairobi, 2003Publisher
University of Nairobi School of Medicine