Outcome and complications of paediatric supracondylar fractures of the humerus as seen at the Kenyatta National Hospital

SUMMARY

Supracondylar fracture of the humerus is a common elbow injury in children.

The main objective of this retrospective study was to determine the epidemiological characteristics, complications and outcome of supracondylar fractures of the humerus in children as seen at Kenyatta National Hospital.

The study found out that supracondylar humeral fractures, had a peak incidence of between four and seven years. Most patients were boys. Fall from height was the commonest cause of injury. Displaced fractures (Gartland IIIa + IIIb) accounted for the majority of these fractures (58.4%). Eighty four point four percent (84.4%) of patients, with undisplaced fractures (Gartland I and II) treated conservatively had good results, while 67.5 % of patients, with displaced fractures treated by open reduction and internal fixation had good results.

Seven (7 of 255) patients, sustained vascular injuries. These were noted to occur in patients with high-energy fracture type (Gartland type IIIa). Compartment syndrome occured in 1.2% (3 of 255) of the patients. All the three patients underwent emergency fasciotomies and at follow-up, they were found to have good limb function.

Twelve patients had neurological lesions. Ten of these recovered fully, without operative intervention.

Long term complications included: - cubitus varus, cubitus valgus, elbow stiffness and myositis ossificans. The incidence of cubitus varus, a common angular deformity, was found to be 12.6 %.

Key conclusions and recommendations were: - back slab-cast, collar and cuff is adequate treatment for undisplaced fractures (Gartland I and II).

Closed reduction and percutaneous pininng method, is underutilized at Kenyatta National Hospital and needs to be actively promoted.

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