Objective: To compare the outcomes of pediatric supracondylar humerus fractures treated during daytime hours to those treated after-hours.
Design: Retrospective.
Setting: Academic Level I trauma center.
Patients/participants: Two hundred ninety-eight pediatric patients treated with surgical reduction and fixation of closed supracondylar fractures were included.
Intervention: Seventy-seven patients underwent surgery during daytime hours (06:00-15:59 on weekdays). One hundred eighty-six patients underwent surgery after-hours (16:00-05:59 on weekdays and any surgery on weekends or holidays).
Main Outcome Measures: Surgeon subspecialty, operative duration, and radiographic and clinical outcomes, including range of motion and carrying angle, were extracted from the patient medical records.
Results: There were no patient-related demographic differences between the daytime hours and after-hours groups. Daytime surgery was more likely to be performed by a pediatric orthopaedic surgeon than after-hours surgery. Fractures treated after-hours had more severe injury patterns. After-hours surgery was not independently associated with rate of open reduction, operative times, complications, achievement of functional range of motion, or radiographic alignment. A late-night surgery subgroup analysis demonstrated an increased rate of malunion in patients undergoing surgery between the hours of 23:00 and 05:59.
Conclusions: There is no difference in the operative duration or outcomes after surgical treatment of pediatric supracondylar humerus fractures performed after-hours when compared with daytime surgery. However, late-night surgery performed between 23:00 and 05:59 may be associated with a higher rate of malunion. Surgeons can use these data to make better-informed decisions about the timing of surgery in this patient population.
Level Of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/BOT.0000000000001134 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Elbow rotation affects the accuracy of rotational formulas: validation of a modified method.
BMC Musculoskelet Disord
January 2025
Pediatric Orthopedic Hospital, Honghui Hospital, Xi'an Jiao tong University, Xi'an, 710000, China.
Background: Supracondylar humerus fractures (SCHFs) are the most common elbow fractures in children and are typically treated with closed reduction and Kirschner pin fixation. However, varying degrees of residual rotational displacement may remain after closed reduction. Several methods exist to assess rotational displacement, but none account for the effect of elbow rotation on the results.
View Article and Find Full Text PDFPediatric orthopedic surgeons may perform better in terms of surgical outcomes in type 3 supracondylar humerus fractures: a comparative analysis.
J Pediatr Orthop B
October 2024
The Pediatric Orthopaedics Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Supracondylar fractures of the humerus represent the most common surgical fractures in pediatric patients. There is a discourse regarding the influence of the surgeon training on treatment. Different studies show equivocal effect of subspecialty training.
View Article and Find Full Text PDFThe standard treatment for displaced pediatric supracondylar fracture of humer us (PSCFH) is closed reduction and percutaneous pinning under image intensifier guidance. This technical note describes Kapandji intrafocal pinning technique (KIPT) for achieving optimal fracture reduction and stable fixation in Gartland Type III or IV extension type PSCFH. In KIPT, a K wire was introduced into the fracture site from the posterior aspect, fracture manipulation was done by levering with wire reducing the posterior displacement of the distal fragment and the wire was fixed to the anterior cortex of the proximal fragment.
View Article and Find Full Text PDFPediatric orthopedic all-terrain vehicle injury patterns, surgeries, and complications: appreciating the true morbidity and impact.
J Pediatr Orthop B
December 2024
Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
All-terrain vehicle (ATV) accidents frequently cause orthopedic injuries. Previous studies have reported the frequency of fractures in ATV injuries. No studies have provided detailed assessments of fracture patterns, types of operative intervention, or risks for multiple surgeries.
View Article and Find Full Text PDFBiomechanical assessment of Kirschner wires integrated with a novel external fixation device for treatment of pediatric supracondylar humeral fracture: a finite element analysis.
Front Bioeng Biotechnol
December 2024
Bone and Joint Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
Background: Pediatric supracondylar humeral fractures present considerable surgical challenges due to the difficulty of achieving proper fracture alignment and stable fixation while avoiding injury to the ulnar nerve. This study assesses the biomechanical performance of a novel Kirschner wire (K-wire) fixation device (KFD), designed to enhance stability and reduce complications linked to traditional K-wire configurations.
Methods: Using finite element analysis (FEA), we evaluated four fixation strategies for treatment of pediatric supracondylar humeral simple transverse fractures: crossed pin fixation, crossed pin fixation with KFD, two lateral pin fixation, and two lateral pin fixation with KFD, under various mechanical loads.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!