Academic Journal

Predictors Associated with the Need for Open Reduction of Pediatric Supracondylar Humerus Fractures ; A Meta-analysis of the Recent Literature

التفاصيل البيبلوغرافية
العنوان: Predictors Associated with the Need for Open Reduction of Pediatric Supracondylar Humerus Fractures ; A Meta-analysis of the Recent Literature
المؤلفون: Transtrum, M. Bryant, Sanchez, Diego, Griffith, Shauna, Godinez, Brianna, Singh, Vishwajeet, Klahs, Kyle J., Abdelgawad, Amr, Thabet, Ahmed M.
المصدر: JBJS Open Access ; volume 9, issue 3 ; ISSN 2472-7245
بيانات النشر: Ovid Technologies (Wolters Kluwer Health)
سنة النشر: 2024
الوصف: Background: Supracondylar humerus (SCH) fractures are some of the most common fractures in pediatric patients with surgery typically consisting of either open or closed reduction with internal fixation. The aim of this meta-analysis was to identify patient, injury, and administrative factors that are associated with treating pediatric SCH fractures with open techniques. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, PubMed and CINAHL database searches were conducted for studies from 2010 to 2023 that made direct comparisons between open reduction and internal fixation (ORIF) and closed reduction and percutaneous pinning (CRPP) for treating SCH fractures in the pediatric population. The search terms used were “pediatric” AND “SCH fracture” OR “distal humerus fracture.” Screening, quality assessment, and data extraction were performed by 4 reviewers. After testing for heterogeneity between studies, data were aggregated using random-effects model analysis. Results: Forty-nine clinical studies were included in the meta-analysis. Summated, there were 94,415 patients: 11,329 treated with ORIF and 83,086 treated with CRPP. Factors that were significantly associated with greater rates of ORIF included obesity (p = 0.001), Gartland type IV fractures (p < 0.001), general neurological deficits (p = 0.019), and ulnar nerve deficits (p = 0.003). Gartland type II (p = 0.033) and medially displaced fractures (p = 0.011) were significantly associated with lower rates of ORIF. Secondary analysis showed cross-pinning constructs (p = 0.033) and longer hospital stays (p = 0.005) are more likely to be observed in patients undergoing ORIF compared with CRPP. Conclusion: This meta-analysis demonstrates that factors such as obesity, fracture displacement, and concomitant nerve deficits are more likely to require ORIF as opposed to CRPP. Level of Evidence: Therapeutic Level III .
نوع الوثيقة: article in journal/newspaper
اللغة: English
DOI: 10.2106/jbjs.oa.24.00011
DOI: 10.2106/JBJS.OA.24.00011
الاتاحة: http://dx.doi.org/10.2106/jbjs.oa.24.00011
https://journals.lww.com/10.2106/JBJS.OA.24.00011
Rights: http://creativecommons.org/licenses/by-nc-nd/4.0/
رقم الانضمام: edsbas.A36FC305
قاعدة البيانات: BASE
الوصف
DOI:10.2106/jbjs.oa.24.00011