Abstract: Introduction: There is no set protocol for treatment of supracondylar humerus presenting more than 6 days after injury. Older studies indicate treatment with traction or leaving them alone to malunite and treat with an osteotomy later in view of significant complications or attempting delayed treatment. The aim of the current study was to look at the outcome of supracondylar humerus fractures presenting after a delay of minimum 6 days.
Patient and Methods: A retrospective study of 14 pediatric patients with supracondylar humerus fractures was undertaken with review of patient’s records and radiographs for pre-operative, intra- operative and post-operative follow up data. Delay between injury and presentation, need for open reduction, operative time and length of stay, post-operative complications, malunion, heterotopic ossification and neuro-vascular injury were evaluated. Patients were called for follow up to evaluate outcomes using the Pediatric Outcome Data Collection Instrument (PODCI) score.
Results: The average age of the patient was 8 years. The average time from injury to surgery was 7.2 days and the patients were in the hospital for 3.2 days (Range: 2 to 8 days). The average operative time was 67.5 minutes. Only two out of 14 patient’s required open reduction while the others could be reduced closed. None of the patients developed heterotopic ossification, residual coronal plane deformities, iatrogenic nerve injuries or vascular compromise at the latest follow up. The overall outcome as assessed with PODCI scoring in 10 out of 14 patients was excellent. (91.5 out of 100)
Conclusion: Majority of supracondylar humerus fractures presenting late can be closed reduced and percutaneously fixed giving excellent clinical outcomes with no residual deformity and complications.
