Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Nov 18, 2023; 14(11): 791-799
Published online Nov 18, 2023. doi: 10.5312/wjo.v14.i11.791
Time of surgery and surgeon level in supracondylar humerus fractures in pediatric patients: A retrospective study
Ibrahim A Albrahim, Ammar K AlOmran, Dalal A Bubshait, Yaser Tawfeeq, Arwa Alumran, Jaffar Alsayigh, Ammar Abusultan, Abdulraheem Altalib, Zaid A Alzaid, Shayma S Alsubaie, Mohammad M Alzahrani
Ibrahim A Albrahim, Ammar K AlOmran, Dalal A Bubshait, Yaser Tawfeeq, Jaffar Alsayigh, Ammar Abusultan, Abdulraheem Altalib, Zaid A Alzaid, Shayma S Alsubaie, Mohammad M Alzahrani, Department of Orthopedic, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
Arwa Alumran, Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
Author contributions: Albrahim IA, Alomran AK, and Bubshait DA contributed to concept; Albrahim I, Alomran AK, Bubshait DA, Tawfeeq Y, Alsayigh J, Abusultan A, Altalib A, Alzaid ZA, Alzahrani MM contributed to design; Albrahim I, Alomran AK, and Bubshait DA, Tawfeeq Y, Alumran A, Alsayigh J, Abusultan A, Altalib A, Alzaid ZA, and Alsubaie SS contributed to study execution; Albrahim I, Alomran AK, and Bubshait DA, Tawfeeq Y, Alumran A, Altalib A, Alzaid ZA, Alsubaie SS, Alzahrani MM contributed to manuscript writing and review; Alumran A contributed to statistical analysis; Alsubaie SS contributed to statistical analysis.
Institutional review board statement: Ethical approval was obtained from the Imam Abdulrahman Bin Faisal University review board (IRB-UGS-2019-01-333).
Informed consent statement: No informed consent was required for patients in this study as it was a retrospective chart review.
Conflict-of-interest statement: All the authors have no relevant conflict of interests.
Data sharing statement: Raw data and material are available as needed.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mohammad M Alzahrani, FRCS, MD, MSc, Assistant Professor, Department of Orthopaedic, College of Medicine, Imam Abdulrahman Bin Faisal University, King Faisal Road, Dammam, Dammam 34212, Saudi Arabia. mmalzahrani@iau.edu.sa
Received: August 23, 2023
Peer-review started: August 23, 2023
First decision: September 14, 2023
Revised: September 18, 2023
Accepted: October 8, 2023
Article in press: October 8, 2023
Published online: November 18, 2023
Processing time: 84 Days and 9.6 Hours
Abstract
BACKGROUND

Supracondylar humerus fractures account for more than 60% of all elbow fractures and about 1/5 of all pediatric fractures. Unfortunately, these fractures can be associated with risk of complications including neurovascular injuries, malunions and limb deformities. Controversy exists regarding the effect of time of surgical intervention and/or level of surgeon performing the surgery on outcome of these fractures.

AIM

To determine whether time of surgical intervention and/or surgeon level influence the outcomes of surgically managed pediatric supracondylar humerus fractures.

METHODS

We retrospectively studied 155 pediatric patients presenting with a supracondylar humerus fracture in a level 1 trauma center from January 2006 to December 2019. The data extracted included demographic data, fracture characteristics, surgical data, and follow-up outcomes. The collected data was analyzed and P values of < 0.05 were considered statistically significant.

RESULTS

Of the cohort, 11% of patients had documented post-operative complications, of which the majority occurred in surgeries performed after day time working hours and in fractures requiring open reduction. While the lowest complication rate was found in surgeries performed by pediatric orthopaedic surgeons, this did not reach statistical significance.

CONCLUSION

In pediatric patients undergoing surgery for supracondylar fractures, we found a higher complication rate when surgeries were not performed during working hours. Surgeon level and training had no significant effect on the risk of post-operative complications.

Keywords: Supracondylar humerus; Fracture; Time of surgery; Level; Complications

Core Tip: In our pediatric cohort of surgically treated supracondylar humerus fractures we found a higher complication rate when surgeries were not performed during working hours. Surprisingly, surgeon level and training had no significant effect on the risk of post-operative complications.