Retrospective analysis of the determining factors for open reduction in pediatric humerus supracondylar fractures: Are factors such as time until operation and surgeon's experience effective?

Yıl 2023, Cilt: 7 Sayı: 3, 254 - 258, 31.12.2023

Murat Taşcı Muhammed Enes Karatas Bahattin Kemah

https://doi.org/10.30565/medalanya.1396535

Öz

Aim: indications for open surgery are very limited in supracondylar humerus fractures (SCHFs).
In our study, we aimed to examine whether the patient’s fracture type, waiting time of the patient before the operation, and the experience of the surgeon are effective on the treatment decision for open surgical method in our SCHF patients treated with open reduction.

Methods: A group of pediatric patients treated with open reduction for SCHF between the years of 2010 and 2022 were examined for our study. Trauma mechanism, type of fracture, time until operation, neurovascular injuries and years of experience of the surgeons were retrospectively reviewed.

Results: A total of 110 patients were included in the study. The mean age was 5.7 years. Nine patients were flexion-type SCHF. According to the Gartland classification, 19 patients were Type II and 82 patients were Type III. Ninety-four patients were operated in the first 24 hours, 16 patients were operated after 24 hours. There was no statistical correlation between the surgeons’ experience or time until operation and the type of the fractures. Patients with flexion type fractures were significantly older than the other patients.

Conclusion: Extension Type III fractures are often require open surgery regardless of the surgeon's experience and waiting time for surgery. Regardless of the surgeon's years of experience and the type of the fracture, some fractures cannot be treated with closed reduction and require open reduction.

Anahtar Kelimeler

pediatric supracondylar humerus fractures, open reduction, surgeon’s experience, time until surgery

Pediatrik humerus suprakondiler kırıklarında açık redüksiyonu belirleyen faktörlerin retrospektif analizi: Operasyona kadar geçen süre ve cerrahın deneyimi gibi faktörler etkili midir?

Öz

Amaç: Suprakondiler humerus kırıklarında (SKHK) açık cerrahi için kesin endikasyonlar çok sınırlıdır. Çalışmamızda açık redüksiyon ile tedavi edilen SKHK hastalarımızda, hastanın kırık tipi, operasyon öncesi hastanın bekleme süresi ve cerrahın deneyiminin açık cerrahi yöntem için tedavi kararında etkili olup olmadığını incelemeyi amaçladık.

Yöntem: Çalışmamız için 2010-2022 yılları arasında SKHK nedeniyle açık redüksiyon ile tedavi edilen çocuk hasta grubu incelendi. Travma mekanizması, kırık tipi, operasyona kadar geçen süre, nörovasküler yaralanmalar ve cerrahların yıllara dayanan deneyim süreleri retrospektif olarak incelendi.

Bulgular: Çalışmaya toplam 110 hasta dahil edildi. Ortalama yaş 5.7 idi. 9 hasta fleksiyon tipi SKHK idi. Gartland sınıflamasına göre 19 hasta Tip II, 82 hasta Tip III idi. 94 hasta ilk 24 saatte, 16 hasta 24 saat sonra ameliyat edildi. Cerrahların deneyimi veya ameliyata kadar geçen süre ile kırık tipi arasında istatistiksel bir ilişki yoktu. Fleksiyon tipi kırığı olan hastalar diğer hastalardan anlamlı olarak daha ileri yaştaydı.

Sonuç: Cerrahın tecrübesi ve kırığın türü ne olursa olsun, bazı kırıklar kapalı redüksiyonla tedavi edilemez ve açık redüksiyon sonrası fikse edilirler. Özellikle ekstansiyon tipi Gartland Tip III kırıklar, cerrahın deneyimine ve ameliyat için bekleme süresine bakılmaksızın genellikle açık redüksiyon gerektirir.

Anahtar Kelimeler

Çocuk humerus suprakondil kırıkları, açık redüksiyon, cerrahın deneyimi, cerrahiye kadar geçen süre

Kaynakça

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