ArticleJournal of the Pediatric Orthopaedic Society of North America2026
Fracture Patterns, Skeletal Age, and Outcomes in Adolescent Supracondylar Humerus Fractures Treated With Open Reduction Internal Fixation.
Article in Journal of the Pediatric Orthopaedic Society of North America, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Supracondylar humerus fractures (SCHF) in adolescents transitioning to skeletal maturity are less common, and literature on the management of complex cases with open reduction internal fixation (ORIF) is limited. The objective of this study was to retrospectively evaluate SCHFs treated with ORIF at a single tertiary pediatric center. Methods: Patients of ages 7-18 who received ORIF between 2015 and 2024 for SCHF with intercondylar extension (T-type; OTA/AO 13-E/4.2) or extraarticular SCHF (eSCHF; OTA/AO 13-M/3.1, 13/E/1.1) were included. Patients treated with percutaneous pinning alone or with prior elbow fractures were excluded. Demographic characteristics, skeletal age, injury mechanism, fracture morphology, and fixation strategy were compared. Outcomes included fracture union, range of motion (ROM), and complications. Stiffness was defined using Morrey's criteria. Final ROM was graded as defined by Jarvis et al. Results: Twenty-eight patients (12.7 years, 45% Female) were included and represented 3% of SCHFs in this age range. The T-type group (n = 14) was older and more skeletally mature (modified Sauvegrain score 6.8 vs 4.5; Conclusions: T-type SCHF were seen in skeletally mature patients and were associated with slower ROM recovery. Fixation strategy was correlated with fracture type. There were no significant differences in clinical outcomes between the two fixation methods. Future prospective studies are warranted to optimize the treatment of adolescent SCHF injuries. Key Concepts: (1)Patients with SCHF with intraarticular extension were older and more skeletally mature.(2)Plate and screws were preferred over cannulated screws for intraarticular extension.(3)All fractures achieved union and final arc of motion did not differ by fracture type.(4)Elbows with T-type fractures were immobilized 1 week less but stiffer at 3-months.(5)Complication rate was high at 64%, and half were due to hardware pain. Level of Evidence: III, Retrospective Cohort Study.
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