University of Oulu

Eira Kuoppala, Roope Parviainen, Tytti Pokka, Minna Sirviö, Willy Serlo & Juha-Jaakko Sinikumpu (2016) Low incidence of flexion-type supracondylar humerus fractures but high rate of complications, Acta Orthopaedica, 87:4, 406-411, DOI:10.1080/17453674.2016.1176825

Low incidence of flexion-type supracondylar humerus fractures but high rate of complications : a population-based study during 2000–2009

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Author: Kuoppala, Eira1; Parviainen, Roope1; Pokka, Tytti1;
Organizations: 1Department of Children and Adolescents, Pediatric Surgery and Orthopedics, Oulu University Hospital, Medical Research Center Oulu, Oulu University PEDEGO Research Group, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1 MB)
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Language: English
Published: Informa, 2016
Publish Date: 2017-02-01


Background and purpose: Supracondylar humerus fractures are the most common type of elbow fracture in children. A small proportion of them are flexion-type fractures. We analyzed their current incidence, injury history, clinical and radiographic findings, treatment, and outcomes.

Patients and methods: We performed a population-based study, including all children <16 years of age. Radiographs were re-analyzed to include only flexion-type supracondylar fractures. Medical records were reviewed and outcomes were evaluated at a mean of 9 years after the injury. In addition, we performed a systematic literature review of all papers published on the topic since 1990 and compared the results with the findings of the current study.

Results: During the study period, the rate of flexion-type fractures was 1.2% (7 out of 606 supracondylar humeral fractures). The mean annual incidence was 0.8 per 105. 4 fractures were multidirectionally unstable, according to the Gartland-Wilkins classification. All but 1 were operatively treated. Reduced range of motion, changed carrying angle, and ulnar nerve irritation were the most frequent short-term complications. Finally, in the long-term follow-up, mean carrying angle was 50% more in injured elbows (21°) than in uninjured elbows (14°). 4 patients of the 7 achieved a satisfactory long-term outcome according to Flynn’s criteria.

Interpretation: Supracondylar humeral flexion-type fractures are rare. They are usually severe injuries, often resulting in short-term and long-term complications regardless of the original surgical fixation used.

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Series: Acta orthopaedica
ISSN: 1745-3674
ISSN-E: 1745-3682
ISSN-L: 1745-3674
Volume: 87
Issue: 4
Pages: 406 - 411
DOI: 10.1080/17453674.2016.1176825
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
Funding: This study was supported by Alma and K.A. Snellman foundation, Vaasa Foundation of Physicians, The Finnish Medical Foundation, The Emil Aaltonen Foundation, Finska Läkaresällskapet and the Medical Society of Finland.
Copyright information: © 2016 The Author(s). Published by Taylor & Francis on behalf of the Nordic Orthopedic Federation. This is an Open Access article distributed under the terms of the Creative Commons Attribution-Non-Commercial License (