Outcome of Delayed Treatment of Supracondylar Elbow Fractures in Children in Hasan Sadikin Hospital Bandung and Santosa Hospital Bandung

OBJECTIVES: Supracondylar fractures of the elbow are common in children and percutaneous pinning usually advocated as a treatment for this kind of fracture. However, the treatment is often delayed in areas where healthcare resources are limited. The objective of this retrospective study was to assess functional outcomes after delayed treatment of supracondylar elbow fractures in children. METHODS: We retrospectively reviewed the medical charts of 38 children aged 2 to 15 years in whom surgery for extension-type supracondylar elbow fractures was delayed by more than 1 week. The 22 boys and 16 girls with a mean age of 5 years 3 months had severe fracture displacement (12 stages III and 26 stage IV according to Lagrange and Rigault classification scheme). The mean time to treatment was 7 days (range: 1-4 weeks). Open reduction and crossed K-wire fixation via the posterior approach were performed in all patients. Functional outcomes were evaluated using Flynn’s criteria. RESULTS: Outcomes were satisfactory in 31 (81,5%) of patients. At last follow-up after a mean of 3 months, three (7,8%) patients had limited in elbow motion. No case of compartment syndrome, surgical site infection and re-operation. CONCLUSION: Despite an average time to surgery of 16 days, the outcome was satisfactory in (81,5%) of cases. Delayed treatment was not associated with an increased rate of postoperative complications.