Article Text

G299(P) Delayed reduction in supracondylar fractures
  1. J Sanpera Iglesias1,
  2. I Sanpera2
  1. Acute Medical Unit, Southmead Hospital, NBT Trust, Bristol, UK
  2. Paediatric Orthopaedics, Hospital Son Espases, Palma de Mallorca, Spain


Aims To study whether a delayed reduction of supracondylar fractures is safe or not.

Methods Retrospective review of 169 supracondylar fractures type 2 and 3 (Gartland classification) seen during the period of January 2010-June 2014. Randomisation was largely determined by time of arrival to our hospital, as we are a referral centre for Paediatric Orthopaedics. The surgery was carried out by a trained paediatric Orthopaedic surgeon or under his direct supervision. The variables studied were: time interval from the accident to surgery; pre- and postoperative neurological and vascular condition; duration and type of surgery; quality of reduction (only for Gartland 3) and; postoperative complications. For study purposes, patients were divided into 2 groups: those operated <6 hours from the time of fracture (early group) and those operated >6 hours (late group). Gartland 2 and 3 fractures were analysed independently. Pulseless limbs on arrival were excluded as they were treated emergently

Results A total of 98 fractures were operated in the ‘early’ group and, 71 in the ‘late’ group. 2 patients in the late group required open reduction. Both had neurological injury on presentation and during reduction became pulseless. 8 cases needed second reduction under GA due to unacceptable position, either because of unsatisfactory reduction or secondary displacement. 5 belonged to the early group and 3 to the late. The most important factor related to surgery duration was the presence of a neurological deficit. See table1. The incidence of neurological injury related to the time was analysed. See table2.

Conclusion The delay in treatment did not determine the appearance of a neurological deficit. Delayed reduction of supracondylar fractures type 3 can be safely done provided there are no associated neurological injuries at presentation.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.