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Purpose <p>Supracondylar fracture of humerus accounts for 60% of all fractures around the elbow and represents 3% of all fractures in children. It is not uncommon to see these fractures presenting late to the hospital and its treatment is debatable. This study aims at defining delayed presentation, its causes, indications, and outcomes of open reduction and internal fixation in these fractures.</p> Methods <p>This is a prospective observational study conducted between 2019 and 2022 at a Pediatric tertiary care hospital. The study population includes all patients within 18&#xa0;years of age with delayed presentation of supracondylar fracture humerus, presenting between 7 and 21&#xa0;days after injury. All children underwent open reduction and internal fixation via medial approach. Postoperatively, children were followed up monthly for 3&#xa0;months and then quarterly for up to one year. At each visit, each child was evaluated clinically for elbow range of motion, carrying angle and radiological assessments were carried out. The end result was assessed using the Flynn’s criteria.</p> Result <p>Out of 28 fractures, all of them achieved sound union by 8&#xa0;weeks. The majority of them were boys accounting for 64.2% and 35.8% were girls with a mean age of eight years [range: 4–14&#xa0;years]. The average duration between injury and surgical intervention was 15&#xa0;days [range: 5–21&#xa0;days]. The average hospital stay was three days [range: 1–5&#xa0;days]. Pin tract infection developed in two patients [7.1%], which resolved with oral antibiotics and K-wire removal after union. None of the patients had myositis ossificans and cubitus varus. The carrying angle was found to be 6° in males [range: 3°–7°] and 10° degrees in females [range: 6°–14°]. Range of movements had recovered fully in 19 patients [67.8%] at the end of 3&#xa0;months, and the remaining nine patients [32.14%] gained full range of motion at the end of 5&#xa0;months.</p> Conclusion <p>Children presenting 7–21&#xa0;days after a supracondylar humerus fracture may be considered delayed cases, often due to initial native treatment or limited specialist access. During this reparative phase, closed reduction is difficult, making open reduction via the medial approach safer and more effective. Early surgery within this window restores alignment, prevents deformity and stiffness, and avoids complex corrective procedures later.</p>

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Delayed Presentation of Pediatric Supracondylar Humerus Fractures: Surgical Approach and Outcomes

  • 期刊论文

  • 发表日期：

    2026年3月8日

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  • Mohammed Yaqub,
  • Kiran Rajappa,
  • M. S. Rudraprasad,
  • Abhishek S. Bhasme

摘要

Purpose

Supracondylar fracture of humerus accounts for 60% of all fractures around the elbow and represents 3% of all fractures in children. It is not uncommon to see these fractures presenting late to the hospital and its treatment is debatable. This study aims at defining delayed presentation, its causes, indications, and outcomes of open reduction and internal fixation in these fractures.

Methods

This is a prospective observational study conducted between 2019 and 2022 at a Pediatric tertiary care hospital. The study population includes all patients within 18 years of age with delayed presentation of supracondylar fracture humerus, presenting between 7 and 21 days after injury. All children underwent open reduction and internal fixation via medial approach. Postoperatively, children were followed up monthly for 3 months and then quarterly for up to one year. At each visit, each child was evaluated clinically for elbow range of motion, carrying angle and radiological assessments were carried out. The end result was assessed using the Flynn’s criteria.

Result

Out of 28 fractures, all of them achieved sound union by 8 weeks. The majority of them were boys accounting for 64.2% and 35.8% were girls with a mean age of eight years [range: 4–14 years]. The average duration between injury and surgical intervention was 15 days [range: 5–21 days]. The average hospital stay was three days [range: 1–5 days]. Pin tract infection developed in two patients [7.1%], which resolved with oral antibiotics and K-wire removal after union. None of the patients had myositis ossificans and cubitus varus. The carrying angle was found to be 6° in males [range: 3°–7°] and 10° degrees in females [range: 6°–14°]. Range of movements had recovered fully in 19 patients [67.8%] at the end of 3 months, and the remaining nine patients [32.14%] gained full range of motion at the end of 5 months.

Conclusion

Children presenting 7–21 days after a supracondylar humerus fracture may be considered delayed cases, often due to initial native treatment or limited specialist access. During this reparative phase, closed reduction is difficult, making open reduction via the medial approach safer and more effective. Early surgery within this window restores alignment, prevents deformity and stiffness, and avoids complex corrective procedures later.