Supracondylar Humeral Fractures in School Children
Incidence and Aetiology during School Terms and Holidays
Keywords:
Fracture, holidays, school, supracondylar, termAbstract
Background: Supracondylar humeral fracture is a common injury in the paediatric age group. The morbidity from its complications such as vascular injury, compartment syndrome and malunion can last the entire lifetime of the child if not recognised and managed appropriately. The aim of the study is to determine the mechanisms of injury and to compare the incidence during school term and holiday periods in school age children. Patients and Methods: A descriptive retrospective study was carried out at the paediatric orthopaedic unit of an orthopaedic hospital. All school age children with supracondylar humeral fractures between 1 January 2014 and 31 December 2017 were included in the study. The demographic data, mechanism of injury, date of injury (to determine whether school term or holiday), Gartland classification and the mode of management were recorded. Results: A total of 53 patients were reviewed. The mean age was 5.94 ± 2.71 years, with a male: female ratio of 2.8:1. The most common mechanism of injury was fall from a height (30.2%). The overall incidence was 0.25/week over the 4‑year period school term (0.22/week and holiday period 0.47/week). The extension type of injury occurred in 52 (98.1%) patients with 7 (13.5%), 4 (7.7%) and 41 (78.8%) being Gartland type I, II and III, respectively. Conclusion: The most common mechanism of injury was fall from a height and there was an increased incidence during holiday compared to the school term period. Larger studies on safety strategies during holiday activities may reduce the incidence of humeral supracondylar fractures.
References
1. Cheng JC, Shen WY. Limb fracture pattern in different pediatric agegroups: A study of 3,350 children. J Orthop Trauma 1993;7:15‑22.
2. Cheng JC, Ng BK, Ying SY, Lam PK. A 10‑year study of the changesin the pattern and treatment of 6,493 fractures. J Pediatr Orthop1999;19:344‑50.
3. Wilkins KE. Fractures and dislocations of the elbow region. In:Rockwood CA Jr., Wilkins KE, King RE, editors. Fractures in Children. 3rd ed. Philadelphia: JB Lippincott; 1991. p. 526‑617.
4. Wessel LM, Günter SM, Jablonski M, Sinnig M, Weinberg AM. Predicting growth patterns after supracondylar fracture of the humerusin childhood. Orthopade 2003;32:824‑32.
5. Carson S, Woolridge DP, Colletti J, Kilgore K. Pediatric upper extremityinjuries. Pediatr Clin North Am 2006;53:41‑67.
6. Houshian S, Mehdi B, Larsen MS. The epidemiology of elbow fracturein children: Analysis of 355 fractures, with special reference tosupracondylar humerus fractures. J Orthop Sci 2001;6:312‑5.
7. Brubacher JW, Dodds SD. Pediatric supracondylar fractures of the distalhumerus. Curr Rev Musculoskelet Med 2008;1:190‑6.
8. Barr LV. Paediatric supracondylar humeral fractures: Epidemiology,mechanisms and incidence during school holidays. J Child Orthop2014;8:167‑70.
9. Skaggs D, Pershad J. Pediatric elbow trauma. Pediatr Emerg Care1997;13:425‑34.
10. Otsuka NY, Kasser JR. Supracondylar fractures of the humerus inchildren. J Am Acad Orthop Surg 1997;5:19‑26.
11. Khademolhosseini M, Abd Rashid AH, Ibrahim S. Nerve injuries insupracondylar fractures of the humerus in children: is nerve explorationindicated? J Pediatr Orthop B 2013;22:123‑6.
12. Gartland JJ. Management of supracondylar fractures of the humerus inchildren. Surg Gynecol Obstet 1959;109:145‑54.
13. Loder RT, Krodel E, D’Amico K. Temporal variation in pediatricssupracondylar humeral fractures requiring surgical intervention. J ChildOrthop 2012;6:419‑25.
14. Chai KK, Aik S, Sengupta S. Supracondylar fractures of the humerusin children‑an epidemiological study of 132 consecutive cases. Med JMalaysia 2000;55:39‑43.
15. Cheng JC, Lam TP, Maffulli N. Epidemiological features ofsupracondylar fractures of the humerus in Chinese children. J PediatrOrthop B 2001;10:63‑7.
16. Mangwani J, Nadarajah R, Paterson JM. Supracondylar humeralfractures in children: Ten years’ experience in a teaching hospital. J Bone Joint Surg Br 2006;88:362‑5.
17. Landin LA, Danielsson LG. Elbow fractures in children. Anepidemiological analysis of 589 cases. Acta Orthop Scand1986;57:309‑12.
18. Farnsworth CL, Silva PD, Mubarak SJ. Etiology of supracondylarhumerus fractures. J Pediatr Orthop 1998;18:38‑42.
19. Bojovic N, Marjanovic Z, Zivanovic D, Dordevic N, Stojanovic M,Jankovic G, et al. Supracondylar fracture of the humerus in children.Acta Medianae 2012;51:5‑12.
20. Landin LA. Fracture patterns in children. Analysis of 8,682 fractureswith special reference to incidence, etiology and secular changesin a Swedish urban population 1950‑1979. Acta Orthop ScandSuppl 1983;202:1‑9.
Downloads
Published
Issue
Section
License
Copyright (c) 2020 Olatunji Oladapo Babalola, Orlando Anozie Ugwoegbulem, Emeka Bide Izuagba, Oluwaseyi K. Idowu, Adebayo Musifiru Owoola (Author)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors publishing in the Nigerian Journal of Orthopaedics and Trauma retain the copyright to their work.
All articles are published under the Creative Commons Attribution 4.0 International (CC BY 4.0) licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
