Background: While supracondylar (SC) fractures are relatively common in children, the incidence of open injuries is believed to be only 1%. Two prior studies on open SC fractures in children reported an increased incidence of vascular injuries. The purposes of our study were to clarify the incidence, associated conditions, and current treatment for open SC fractures.
Methods: The Pennsylvania Trauma Outcome Study database was queried. Subjects age 25 to 156 months old admitted to trauma centers between January 2000 and December 2015 with a SC fracture were included. Controls were those with closed fractures and the study group, those with open injuries. Study variables were age, sex, weight, injury severity score, length of stay (LOS), nerve injury, ipsilateral forearm fracture, compartment syndrome/fasciotomy, requirement for a vascular procedure. Other variables were mode of treatment, provisional reduction, repeat reduction, time interval between referring facility admission and operation, and time from emergency department admission to operation.
Results: A total of 4308 subjects were included, 104 (2.4%) of whom had an open SC fracture. LOS was 2 days for the study group versus 1 day for controls (P<0.001). Open SC fractures were more likely than closed to be associated with a nerve injury (13.5% vs. 3.7%), ipsilateral forearm fracture (18.3% vs. 6.4%) and/or a vascular procedure (6.7% vs. 0.3%) (P<0.001). 5.9% of those in the study group required repeat surgery compared with 0.4% for controls (P<0.001). Time from emergency department admission to operation was 3.2 versus 10.3 hours (P<0.001).
Conclusions: We report the largest series to date of open SC fractures in children. Surgeons caring for such patients should be aware of their increased risks for both associated injuries and potential requirement for vascular reconstruction. The majority of children with an open SC fracture are managed with 1 operation and in the absence of vascular injury, seldom require an extended LOS.
Level Of Evidence: Level III-retrospective cohort study.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/BPO.0000000000001772 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Intramedullary Nail Failure in a Subtrochanteric Fracture in a 62-Year-Old Woman.
Cureus
December 2024
Department of Surgery, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, USA.
Subtrochanteric fractures in older patients are typically due to low-energy falls. The standard of care is intramedullary nailing. The Smith & Nephew Trigen Intertan (Memphis, TN, US) is an intramedullary nail with a novel design that incorporates two integrated compression screws.
View Article and Find Full Text PDFTime-Critical Emergencies in Suburban Parks and Outdoor Recreation Spaces.
Cureus
December 2024
Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, USA.
Objective Prior studies have described the patterns of emergency medical service (EMS) activations in national parks in the United States. However, little data exists regarding EMS activations in local and regional outdoor recreational locations. We performed a retrospective analysis of EMS activations originating from parks and recreational areas in suburban Howard County, Maryland, to characterize those activations determined to be time-critical emergencies.
View Article and Find Full Text PDFCavernous Sinus Syndrome in a Traumatic Dissecting Aneurysm of the Internal Carotid Artery.
Cureus
December 2024
Department of Ophthalmology, Hospital University Kebangsaan Malaysia, Kuala Lumpur, MYS.
We report a rare case of a missed intracavernous internal carotid artery dissecting aneurysm occurring as a complication of the base of skull fracture with severe brain injury causing acute cavernous sinus syndrome with permanent vision loss. A 31-year-old Myanmar lady had an alleged motor vehicle accident and suffered severe traumatic brain injury with multiple intracranial bleeds, multiple facial bone and base of skull fractures, and limb fractures. At one week post-trauma, she had severe right eye proptosis with vision loss, ophthalmoplegia, chemosis, and high intraocular pressure.
View Article and Find Full Text PDFFluid Management in Critical Care: New Insights Into Optimal Fluid Therapy.
Cureus
December 2024
Critical Care Medicine, Star Care Multispeciality Hospital, Kozhikode, IND.
Background: Fluid management is a crucial critical care component, influencing outcomes such as organ function, renal integrity, and survival in critically ill patients. Recent evidence suggests that balanced crystalloids may offer advantages over isotonic saline, particularly in reducing the risk of acute kidney injury (AKI) and other complications. This study aimed to evaluate the impact of balanced crystalloids versus isotonic saline on clinical outcomes in the intensive care unit (ICU), focusing on AKI, renal replacement therapy (RRT), and mortality.
View Article and Find Full Text PDFDuplication of the Plantaris Tendon and Its Clinical Significance: A Case Report.
Cureus
December 2024
Orthopedics and Traumatology, Unidade Local de Saúde do Nordeste, Macedo de Cavaleiros, PRT.
The plantaris tendon may be absent in some individuals, indicating its unclear function. Anatomically, the plantaris tendon originates from the lateral femoral condyle and has a variable course and insertion point at the calcaneal tuberosity. The plantaris tendon may influence conditions such as Achilles tendinopathy, particularly in its midportion, whether by its close relation to the calcaneal tendon or adhesions between both tendons.
View Article and Find Full Text PDFWant 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!