Age is a predictor of elbow stiffness after type III or IV supracondylar humerus fractures.

Autor: Gupta K; Cedars-Sinai Medical Center, Los Angeles, CA, USA., Erdman MK; Department of Orthopaedic Surgery and Rehabilitation Medicine, University of Chicago Medicine and Biological Sciences, Chicago, IL, USA., Siddiqui A; Department of Orthopaedic Surgery and Rehabilitation, University of Florida College of Medicine-Jacksonville, Jacksonville, FL, USA., Schur M; Department of Orthopaedic Surgery, University of Southern California Keck School of Medicine, Los Angeles, CA, USA., Meisel E; Children's Orthopaedic Center, Children's Hospital Los Angeles, 4650 Sunset Blvd, MS #69, Los Angeles, CA, 90027, USA., Goldstein RY; Children's Orthopaedic Center, Children's Hospital Los Angeles, 4650 Sunset Blvd, MS #69, Los Angeles, CA, 90027, USA. rgoldstein@chla.usc.edu.
Jazyk: angličtina
Zdroj: European journal of orthopaedic surgery & traumatology : orthopedie traumatologie [Eur J Orthop Surg Traumatol] 2024 Aug; Vol. 34 (6), pp. 3067-3071. Date of Electronic Publication: 2024 Jun 25.
DOI: 10.1007/s00590-024-04031-4
Abstrakt: Purpose: Supracondylar humerus (SCH) fractures account for approximately 30% of injuries for those younger than 7 years of age (Cheng et al. in J Pediatr Orthop 19:344-350, 1999). Recent studies examining the association of patient age and SCH fracture outcomes have provided conflicting findings. The purpose of this study is to investigate SCH fracture outcomes in children at different ages of skeletal development.
Methods: Retrospective review of a Level I pediatric trauma center between 2010 and 2014 was conducted. 190 patients with SCH fractures, age < 14 years, fracture type Gartland III or IV (AO/OTA 13-M 3.1 III and IV) were included. Patients were sorted into age groups: < 2 years, 4-6 years, and > 8 years. Patients were treated with either a closed or open reduction with percutaneous fixation. Clinical outcomes including postoperative elbow range of motion, nerve palsy, compartment syndrome, infection, and cubitus varus were assessed.
Results: Patients in younger age groups were more likely to obtain postoperative full elbow flexion (< 2 years = 77%; 4-6 years = 66%; > 8 years = 43%) and full elbow extension (< 2 years = 96%; 4-6 years = 88%; > 8 years = 64%). Age was a significant predictor of nerve palsy on admission, mean operative time (< 2 years = 21.8 min; 4-6 years = 43.0 min; > 8 years = 80.7 min), and mean fluoroscopy time (< 2 years = 22.9 s; 4-6 years = 59.5 s; > 8 years = 171.9 s). There were no differences in rates of open reduction, compartment syndrome, pin tract infection, cubitus varus, or reoperation among groups.
Conclusion: Increasing age is associated with increased elbow stiffness after percutaneous fixation of Gartland Type III and Type IV SCH fractures. Older patients with SCH fractures may benefit from formal rehabilitation.
Level of Evidence: III.
(© 2024. The Author(s).)
Databáze: MEDLINE
Externí odkaz: