ArticleUlusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES2026
Radiographic and clinical factors associated with open reduction in pediatric supracondylar humerus fractures.
Article in Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES, 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
backgroundThe aim of this study was to evaluate demographic and radiographic factors associated with the likelihood of open reduction in pediatric supracondylar humerus fractures (SCHF).
methodsA total of 294 pediatric patients with SCHFs treated operatively between 2016 and 2025 were retrospectively reviewed. Patients were divided into two groups: Open reduction (OR, n=128) and closed reduction (CR, n=166). Demographic variables, including age, sex, side of injury, and surgeon experience, were recorded. Radiographic parameters assessed on preoperative anteroposterior and lateral elbow radiographs included fracture type, displacement direction, rotational deformity, diaphyseal involvement, coronal fracture pattern, sagittal fracture pattern, and coronal alignment. Variables with p<0.05 in univariate analysis were included in a multivariable logistic regression model using a backward stepwise method.
resultsThe mean age was significantly higher in the OR group compared to the CR group (6.94±2.85 vs. 5.58±2.64 years, p<0.001). Flexion-type fractures were more frequent in the OR group (24.2% vs. 10.2%, p=0.012). Posterolateral displacement and rotational deformity were also significantly associated with open reduction. Coronal alignment differed significantly between groups, with varus and valgus malalignment more common in the OR group (p=0.003). Multivariable logistic regression analysis identified increasing age (OR=1.127, 95% confidence interval [CI]: 1.029-1.236; p=0.010), flexion-type fractures (OR=1.807, 95% CI: 1.261-2.590; p=0.001), and posterolateral displacement (OR=1.39, 95% CI: 1.010-1.926; p=0.043) as independent predictors of open reduction. In contrast, neutral coronal alignment was associated with a lower likelihood of open reduction (OR=0.681, 95% CI: 0.510-0.909; p=0.009).
conclusionSeveral demographic and fracture-related characteristics were independently associated with the likelihood of open reduction in pediatric SCHFs. Among these, fracture-related characteristics, particularly displacement pattern and coronal alignment, showed the strongest associations with open reduction. Recognition of these associated factors may assist preoperative planning and help surgeons anticipate technically challenging reductions.
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