Journal Basic Info

  • Impact Factor: 1.995**
  • H-Index: 8
  • ISSN: 2474-1647
  • DOI: 10.25107/2474-1647
**Impact Factor calculated based on Google Scholar Citations. Please contact us for any more details.

Major Scope

  •  Otolaryngology - Head and Neck Surgery
  •  Pediatric Surgery
  •  Ophthalmic Surgery
  •  Emergency Surgery
  •  Gastroenterological Surgery
  •  Surgical Oncology
  •  Neurological Surgery
  •  Orthopaedic Surgery


Citation: Clin Surg. 2016;1(1):1082.Research Article | Open Access

The Treatment of Pediatric Supracondylar Humerus Fractures: Experience in a Tertiary Medical Center in a Rural State

Karnes JM and Lubicky JP

Department of Orthopaedics, West Virginia University, USA

*Correspondance to: John P. Lubicky 

 PDF  Full Text DOI: 10.25107/2474-1647.1082


Background: In our rural state, most children with supracondylar humerus fractures (SCFs) are referred to our tertiary care medical center. Over a 4+ year period, the one pediatric orthopaedic surgeon in the state surgically treated more than 200 SCFs using a standard protocol. Closed reduction (CR) and percutaneous pinning was attempted in all cases. Open reduction and percutaneous pinning (OR/PP) was required in some. The purpose of this study was to review one surgeon’s experience with the surgical treatment of SCF with a focus on fracture type and pattern and the need for open reduction as well as the incidence of nerve injuries.Methods: Institutional Review Board approval for a retrospective chart review was attained and medical records of pediatric patients treated at our institution between 01/2010 and 09/2014 were reviewed. Current Procedural Terminology codes 24538, 24545, and 24546 were used to identify patients. Data were examined using summary statistics and Chi-square tests.Results: Two hundred four patients were included in this study and 25 eventually required OR/ PP for definitive management. The following factors were not statistically associated with OR/PP: fracture pattern, Gartland classification, laterality of extremity, or gender; however, age, presence of neurological symptoms on initial evaluation, and energy of fracture etiology were significantly associated. In 71 cases, a “U” shaped distal fragment was identified. The most common neurological symptoms on initial presentation were anterior interosseous nerve palsy (n=10, 4.9%) and nondermatomal paresthesias (n=5, 2.5%). Factors significantly associated with neurological symptoms on initial presentation included: need for open reduction, medial-lateral pinning construct, Gartland Type III injury, age, and “U-shaped” fracture pattern.Conclusions: No identified fracture pattern was significantly associated with need for open reduction; however, a previously undescribed “U-shaped” fracture pattern did have a significant association with neurological symptoms. Patients most likely to require OR/PP for a SCF were children over the age of five who presented with neurological symptoms on initial evaluation and/or had a high-energy injury etiology. The main indication for OR/PP was failure to achieve a satisfactory CR. Orthopaedic surgeons managing these fractures should have a low threshold to transition to an open procedure in patients with these risk factors if closed fracture reduction cannot be achieved expeditiously.


Supracondylar fracture; Open reduction

Cite the article

Karnes JM, Lubicky JP. The Treatment of Pediatric Supracondylar Humerus Fractures: Experience in a Tertiary Medical Center in a Rural State. Clin Surg. 2016; 1: 1082.

Search Our Journal

Journal Indexed In

Articles in PubMed

Sildenafil Transiently Delays Early Alveolar Bone Healing of Tooth Extraction Sockets
 PubMed  PMC  PDF  Full Text
RAF Kinase Inhibitory Protein Expression and Phosphorylation Profiles in Oral Cancers
 PubMed  PMC  PDF  Full Text
View More...

Articles with Grants

Losartan (AT1R Blockers): Beneficial Effects on COVID-19 Patients
 PDF  Full Text
Ultrasound in Medical Education: Increasing Awareness for Ultrasound Applications in the Novice Learner
 Abstract  PDF  Full Text
View More...