Audit of Surgical Delay and Outcomes in Supracondylar Humerus Fractures in Children

Abstract

Background: Supracondylar humerus fractures are among the most common pediatric orthopedic injuries, particularly in children aged 5 to 8 years. Timely surgical intervention is critical to avoid complications such as malunion, neurovascular compromise, and poor functional outcomes. In resource-limited settings, delays in surgery are frequent and may negatively influence patient recovery.
Aim: This study aimed to audit the relationship between surgical delay and post-operative outcomes in children with supracondylar humerus fractures admitted to the Orthopaedic Department of King Edward Medical University/Mayo Hospital, Lahore, during 2017.
Methods: A retrospective audit was conducted on 120 children aged 2–12 years who underwent surgical treatment for closed supracondylar humerus fractures. Patients were grouped based on surgical delay: <12 hours, 12–24 hours, and >24 hours. Data on demographics, fracture type (Gartland classification), complications, and outcomes were extracted and analyzed using descriptive statistics and chi-square tests, with a significance level set at p < 0.05.
Results: Of the 120 patients, 65% were male and 62.5% had Type III fractures. Surgical delays >24 hours were observed in 25% of cases. Complications, including Volkmann’s ischemic contracture (5%), prolong surgical time and difficulty (8.3%), and longer hospital stay (6.7%), increased with delay. Excellent outcomes were achieved in 87.5% of the <12-hour group compared to 60% in the >24-hour group. A statistically significant association was found between surgical delay and complication rate (χ² = 9.67, p = 0.008).
Conclusion: Early surgical intervention within 12 hours significantly improves outcomes and reduces complications. Prompt operative care should be prioritized in pediatric supracondylar fracture management.