Potential causes of loss of reduction in supracondylar humerus fractures.

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Abstract

[Indexed for MEDLINE] 14. Pol Orthop Traumatol. 2012 Oct 22;77:101-4. Analysis of early vascular and neurological complications of supracondylar humerus fractures in children. Tomaszewski R(1), Gap A, Wozowicz A, Wysocka P. Author information: (1)Chair and Clinic of Paediatric Surgery, Department of Orthopaedics and Traumatology, Upper Silesian Child Health Centre, Katowice, Poland. tomaszewskir@gmail.com BACKGROUND: Supracondylar fracture of the humerus is one of the most common elbow injuries in children. It represents 60% elbow fractures and 16% all pediatric fractures. Extension-type fracture is the most frequent mechanism of this injury. MATERIAL/METHODS: The aim of our study was to analyse early vascular and neurological complications of supracondylar humerus fractures in 122 children hospitalized in the Department of Orthopaedics and Traumatology, determine fracture types and duration of symptoms, as well as to establish methods of early diagnosis and treatment. The study covered cases of patients treated in the years 2004-2010. RESULTS: Acute neurovascular complications occurred in 15% patients with supracondylar fractures (18 children). Nerve damage was found in 11% patients with displaced fractures (12 children). The average duration of symptoms was 49 days (ranging from 2 days to 5 months). Symptoms of vascular injury occurred in 8% children with displaced fractures (8 children) and were characterized by absent or weak pulse of the radial artery. CONCLUSIONS: 1. Fracture reduction is a priority procedure in the cases of displaced supracondylar fracture, while further diagnostic steps and treatment of possible complications should only be applied afterwards. 2. The incidence of vascular and neurological complications positively correlates with fracture progression according to Gartland classification.