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Topic:

Supracondylar Humerus Fracture

Issue:

Elbow

Category:

Trauma

Title:

Risk Factors for Stiffness After Surgical Treatment of Pediatric Humeral Lateral Condyle Fractures: Results of a Multicenter Study

Author:

Tippabhatla, Abhishek BS; Torres-Izquierdo, Beltran MD; Pereira, Daniel E. MD; Goldstein, Rachel MD, MPH; Sanders, Julia MD; Neal, Kevin MD; Bellaire, Laura MD; Denning, Jaime MD; Hosseinzadeh, Pooya MD

Journal:

Journal of Pediatric Orthopaedics

Date:

April 2024

Reference:

44(4): p 208-212, DOI: 10.1097/BPO.0000000000002632

Level Of Evidence:

III

# of Patients:

665

Study Type:

Retrospective multicenter cohort study

Location:

Six level I trauma centers in the United States

Summary:

The study investigated risk factors associated with postoperative stiffness in pediatric humeral lateral condyle fractures and identified factors that could help predict and mitigate stiffness.

Methods:

Multicenter retrospective analysis of children aged 1–12 years with lateral condyle fractures treated surgically between 2005 and 2019. Defined elbow stiffness as requiring physical or occupational therapy or surgery to address limited elbow range of motion. Evaluated patient demographics, fracture characteristics, treatment modalities, and outcomes.

Exclusions:

Cases with incomplete records, prior elbow injuries, or treatment outside the specified timeframe.

Results:

21% of patients experienced postoperative stiffness. Risk factors for stiffness included older patient age, concurrent elbow dislocations, severe fracture patterns, and open reduction. Most patients (96%) were managed with physical or occupational therapy, while 4% required surgical intervention for stiffness.

Conclusions:

Older age, severe fractures requiring open reduction, and associated elbow dislocations increase the risk of postoperative stiffness in pediatric humeral lateral condyle fractures. Families of at-risk patients should be counseled, and early range of motion exercises are recommended to minimize stiffness. Closed reduction should be prioritized in high-risk patients to reduce stiffness risks.

Relevance:

Limitations:

Perspective:

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