Facteurs associés aux échecs de réduction orthopédique des fractures supra-condylienne de l’enfant

Abstract

Purpose of the studyThe aim of this retrospective study is to analyze the risk factors causing the failure of closed reduction of children supracondylar fracture. Materials and methodsThe children with supracondylar humerus fractures who were treated in our hospital from February 2008 to February 2013, were recorded as well as their age, sex, BMI, injured side, mechanism of injury, associated injuries, fracture type, delay from injury to surgery. Mean comparisons or chi-square test were used for univariate analysis of the above factors, and then multivariate logistic regression analysis was used to analyze the possible risk factors, in order to elicit the risk factors associated with a failed closed reduction for supracondylar fractures in children. ResultsUnivariate analysis showed that BMI, fracture type, duration from injury to surgery, and mechanism of injury had statistically significant association with the failure of closed reduction for children supracondylar fracture (P=0.021, 0.044, 0.000 and 0.037 respectively). Multivariate logistic regression analysis demonstrated that fracture type (P=0.027, OR=1.177), time from injury to surgery (P=0.022, OR=2.003), and mechanism of injury (P=0.044, OR=4.182) were independent risk factors of a failed closed reduction for paediatric supracondylar fractures. DiscusionsGartland type III supracondylar fractures, the peak period of soft tissue swelling and high-energy injury are significant risk factors to warrant open reduction. Treating surgeons should preoperatively carefully evaluate these risk factors and be prepared to treat these injuries accordingly. Level of evidenceLevel IV retrospective study.