Short-Term Management Outcomes of Supracondylar Fractures of the Humerus and Their Associated Factors in Children Managed at Mulago National Referral Hospital

Abdirizak Abdullahi Sheikdon; Phillip Mulepo; Gonzaga Waiswa; Samuel Bugeza; Senai Goitom Sereke; Benjamin Mfaume; Sali Patrick; Swaka Amos Jada; Michael Emusugut

doi:10.2147/ORR.S370357

Short-Term Management Outcomes of Supracondylar Fractures of the Humerus and Their Associated Factors in Children Managed at Mulago National Referral Hospital

Orthop Res Rev. 2022 Jul 15:14:235-245. doi: 10.2147/ORR.S370357. eCollection 2022.

Authors

Abdirizak Abdullahi Sheikdon¹, Phillip Mulepo¹, Gonzaga Waiswa¹, Samuel Bugeza², Senai Goitom Sereke², Benjamin Mfaume¹, Sali Patrick¹, Swaka Amos Jada¹, Michael Emusugut¹

Affiliations

¹ Orthopedic Department, Makerere University, Kampala, Uganda.
² Department of Radiology and Radiotherapy, Makerere University, Kampala, Uganda.

Abstract

Purpose: Supracondylar fractures (SCF) of the humerus is one of the commonest global health concerns among children and need a rigorous management process to obtain satisfactory outcomes. It is of paramount importance to use systematic guidelines to aid abate bad fracture outcomes. The study primarily sought to determine the functional and radiological management outcomes of SCF of the humerus in children at Mulago National Referral Hospital (MNRH) and associated factors to the outcomes.

Methods: We conducted a hospital-based, cross-sectional study among children managed for SCF of the humerus at MNRH. Using Flynn's criteria, current flexion and extension at the elbow joints, humeroulnar angle and the neurology were assessed and compared to the contralateral limb to get the functional outcomes. The pre-management digital radiographs of the elbow joint were compared with the current radiographs to assess radiological outcomes. Bivariate and multivariate analyses were used to determine the associated factors.

Results: Of the 77 children, 46 (60%) were male with a mean age of 7.86±2.30 years. Gartland type I fracture constituted 55.8% (43), type II was 29.9% (23) and type III was 14.3% (11). About 88.3% of the patients were managed non-operatively and 11.7% were managed operatively. The overall satisfactory functional outcome was 46.7%, while 81.8% of the patients had a satisfactory radiological outcome at 6 months after the intervention. Delay in seeking treatment, type 1 fracture, and prolonged duration of immobilization were significantly associated with unsatisfactory functional management outcome. Type II fracture and prolonged duration of immobilization were significantly associated with unsatisfactory radiological management of SCF of the humerus.

Conclusion: The short-term functional outcome was unsatisfactory, while a satisfactory radiological outcome was found in most of the patients. Duration of immobilization, type of fracture, and seeking late medical care had a negative impact on the outcome of these fractures.

Keywords: children; fracture; management; outcome; supracondylar.