Short-term follow-up of early reconstructive surgery management in neglected supracondylar humeral fractures

Abstract

BACKGROUND: The supracondylar humeral fracture is a fracture located in the proximal position of the trochlea and humeral capitulum. This fracture is the most common elbow fracture in children. Epidemiological research states that these fractures constitute 58% of all elbow fractures in children. It is also mentioned that 10–20% patients undergo belated admission to get therapy. Based on the literature, the fracture is categorized as neglected if the fracture treatment is 14 days post-trauma. Unfortunately, few reports can provide management guidelines. Some experts mention the “wait and see” attitude toward this fracture until a perfect remodeling happens to correct the deformity; however, a number of studies have shown good results after early reconstruction. AIM: We aimed to evaluate the short-term follow-up of supracondylar humeral fractures that came after 14 days of injury and then open reduction reconstructions were done, followed by the installation of K-wire and screws with the figure of eight patterns based on the quick disabilities of the arm, shoulder, and hand (Q-DASH) 9-score, Flynn’s Criteria, and Mayo Elbow Performance Score (MEPS). METHODS: The samples were five patients who underwent corrective open reduction and injury fixed with Kirschner (K)-wire and screws with the figure of eight patterns using the posterior approach at the Orthopedic Hospital from December 2019 to February 2020. Results were assessed with the quick disabilities of the arm, shoulder, and hand-9 score (Q-DASH-9 score), Flynn’s Criteria, and Mayo Elbow Performance Score (MEPS). RESULTS: All patients after reconstruction correction showed an increase in range of motion in the fractured elbow. No complications were found from the surgical treatment. CONCLUSIONS: Early reconstruction correction of patients with supracondylar humeral fractures gave satisfactory results based on the Q-DASH-9 Score, Flynn’s Criteria, and MEPS.