Predictive factors for open reduction of flexion-type supracondylar fracture of humerus in children
Abstract Objective The incidence of open reduction and internal fixation (ORIF) in flexion-type supracondylar humerus fractures (SCHF) in children is significantly higher than that of extension-type fractures. This study aimed to identify risk factors for ORIF in flexion-type SCHF. Methods One hundr...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-09-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-022-05798-5 |
| _version_ | 1811267620939235328 |
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| author | Jun Sun Jing Shan Lian Meng Tianjing Liu Enbo Wang Guoqiang Jia |
| author_facet | Jun Sun Jing Shan Lian Meng Tianjing Liu Enbo Wang Guoqiang Jia |
| author_sort | Jun Sun |
| collection | DOAJ |
| description | Abstract Objective The incidence of open reduction and internal fixation (ORIF) in flexion-type supracondylar humerus fractures (SCHF) in children is significantly higher than that of extension-type fractures. This study aimed to identify risk factors for ORIF in flexion-type SCHF. Methods One hundred seventy-one patients with Wilkins type III flexion-type SCHF from January 2012 to December 2021 were retrospectively enrolled in a tertiary paediatric hospital. Patients were divided into ORIF group versus closed reduction and internal fixation (CRIF) group. Then, patients data of age, sex, injury side, obesity, deviation of displacement, fracture level, rotation, nerve injury, and delay from injury to surgery were reviewed. Univariate analysis and multivariate logistic regression were used to identify independent risk factors and odds ratios (OR) of ORIF. Results Overall, 171 children with type III flexion-type SCHF were analyzed (average aged 7.9 ± 2.8 years). Displacement was lateral in 151 cases, medial in 20. 20 cases had combined ulnar nerve injury. The failed closed reduction rate was 20%. Univariate analysis indicated age, distal fracture fragment rotation, and ulnar nerve injury were significantly associated with ORIF. (P = 0.047, P = 0.009, and P = 0.001, respectively). Multivariate logistic regression analysis showed that distal fracture fragment rotation (OR, 3.3; 95%CI:1.1–9.5; P = 0.028) and ulnar nerve injury (OR, 6.4; 95%CI:2.3–18.3; P = 0.001) were independent risk factors; however, the age was not an independent one (OR, 1.5; 95%CI:0.6–3.5; P = 0.397) for ORIF in the Wilkins type III flexion-type SCHF. Conclusion Distal fracture fragment malrotation on initial x-rays and ulnar nerve injury were significant risk factors for ORIF in Wilkins type III flexion-type SCHF. Surgeons should prepare tourniquets or other open reduction instruments when treating these types of fractures. Level of evidence Level IV |
| first_indexed | 2024-04-12T21:07:14Z |
| format | Article |
| id | doaj.art-6c0acb35b9694bc29011dea77b6bad71 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-04-12T21:07:14Z |
| publishDate | 2022-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-6c0acb35b9694bc29011dea77b6bad712022-12-22T03:16:41ZengBMCBMC Musculoskeletal Disorders1471-24742022-09-012311610.1186/s12891-022-05798-5Predictive factors for open reduction of flexion-type supracondylar fracture of humerus in childrenJun Sun0Jing Shan1Lian Meng2Tianjing Liu3Enbo Wang4Guoqiang Jia5Children’s Hospital of Fudan University Anhui HospitalChildren’s Hospital of Fudan University Anhui HospitalChildren’s Hospital of Fudan University Anhui HospitalDepartment of Pediatric Orthopaedics, Shengjing Hospital of China Medical UniversityDepartment of Pediatric Orthopaedics, Shengjing Hospital of China Medical UniversityChildren’s Hospital of Fudan University Anhui HospitalAbstract Objective The incidence of open reduction and internal fixation (ORIF) in flexion-type supracondylar humerus fractures (SCHF) in children is significantly higher than that of extension-type fractures. This study aimed to identify risk factors for ORIF in flexion-type SCHF. Methods One hundred seventy-one patients with Wilkins type III flexion-type SCHF from January 2012 to December 2021 were retrospectively enrolled in a tertiary paediatric hospital. Patients were divided into ORIF group versus closed reduction and internal fixation (CRIF) group. Then, patients data of age, sex, injury side, obesity, deviation of displacement, fracture level, rotation, nerve injury, and delay from injury to surgery were reviewed. Univariate analysis and multivariate logistic regression were used to identify independent risk factors and odds ratios (OR) of ORIF. Results Overall, 171 children with type III flexion-type SCHF were analyzed (average aged 7.9 ± 2.8 years). Displacement was lateral in 151 cases, medial in 20. 20 cases had combined ulnar nerve injury. The failed closed reduction rate was 20%. Univariate analysis indicated age, distal fracture fragment rotation, and ulnar nerve injury were significantly associated with ORIF. (P = 0.047, P = 0.009, and P = 0.001, respectively). Multivariate logistic regression analysis showed that distal fracture fragment rotation (OR, 3.3; 95%CI:1.1–9.5; P = 0.028) and ulnar nerve injury (OR, 6.4; 95%CI:2.3–18.3; P = 0.001) were independent risk factors; however, the age was not an independent one (OR, 1.5; 95%CI:0.6–3.5; P = 0.397) for ORIF in the Wilkins type III flexion-type SCHF. Conclusion Distal fracture fragment malrotation on initial x-rays and ulnar nerve injury were significant risk factors for ORIF in Wilkins type III flexion-type SCHF. Surgeons should prepare tourniquets or other open reduction instruments when treating these types of fractures. Level of evidence Level IVhttps://doi.org/10.1186/s12891-022-05798-5HumerusSupracondylar fractureFlexionClosed reductionRisk factors |
| spellingShingle | Jun Sun Jing Shan Lian Meng Tianjing Liu Enbo Wang Guoqiang Jia Predictive factors for open reduction of flexion-type supracondylar fracture of humerus in children BMC Musculoskeletal Disorders Humerus Supracondylar fracture Flexion Closed reduction Risk factors |
| title | Predictive factors for open reduction of flexion-type supracondylar fracture of humerus in children |
| title_full | Predictive factors for open reduction of flexion-type supracondylar fracture of humerus in children |
| title_fullStr | Predictive factors for open reduction of flexion-type supracondylar fracture of humerus in children |
| title_full_unstemmed | Predictive factors for open reduction of flexion-type supracondylar fracture of humerus in children |
| title_short | Predictive factors for open reduction of flexion-type supracondylar fracture of humerus in children |
| title_sort | predictive factors for open reduction of flexion type supracondylar fracture of humerus in children |
| topic | Humerus Supracondylar fracture Flexion Closed reduction Risk factors |
| url | https://doi.org/10.1186/s12891-022-05798-5 |
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