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CC BY 4.0 · J Brachial Plex Peripher Nerve Inj 2023; 18(01): e27-e31
DOI: 10.1055/s-0043-1771012
Original Article

Impact of Preoperative Neuropraxia on Surgical Duration Following Pediatric Supracondylar Fracture of the Humerus: A Retrospective Cohort Study

Yazeed Alayed 
1   Department of Pediatrics, Children Hospital, King Saud Medical City, Ulaishah, Riyadh, Saudi Arabia
,
Bander S. Alrashedan
2   Department of Orthopedic Surgery, King Saud Medical City, Ulaishah, Riyadh, Saudi Arabia
,
Sultan K. Almisfer
2   Department of Orthopedic Surgery, King Saud Medical City, Ulaishah, Riyadh, Saudi Arabia
,
Ali M. Aldossari
3   Division of Paediatric Orthopaedic Surgery, Department of Orthopedic Surgery, King Saud Medical City, Ulaishah, Riyadh, Saudi Arabia
› Author Affiliations Funding This study did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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Abstract

Background Supracondylar fractures of the humerus (SCFHs) are the most common type of elbow fracture in children. Because of the influence on functional outcome, neuropraxia is one of the most common concerns at presentation. The impact of preoperative neuropraxia on surgery duration is not extensively probed. The clinical implications of several other risk factors associated with preoperative neuropraxia at presentation may contribute to longer surgical duration of SCFH.

Hypothesis Preoperative neuropraxia is likely to increase surgery duration in patients who sustained SCFH.

Patients and Methods This is a retrospective cohort analysis. Sixty-six patients who sustained surgical pediatric supracondylar humerus fracture were included in the study. Baseline characteristics including age, gender, the type of fracture according to Gartland classification, mechanism of injury, patient weight, side of injury, and associated nerve injury were included in the study. Logistic regression analysis was performed using mean surgery duration as the main dependent variable and age, gender, fracture type according to the mechanism of injury, Gartland classification, injured arm, vascular status, time from presentation to surgery, weight, type of surgery, medial K-wire use, and afterhours surgery as the independent variables. A follow-up of 1 year was implemented.

Result The overall preoperative neuropraxia rate was 9.1%. The mean surgery duration was 57.6 ± 5.6 minutes. The mean duration of closed reduction and percutaneous pinning surgeries was 48.5 ± 5.3 minutes, whereas the mean duration of open reduction and internal fixation (ORIF) surgeries was 129.3 ± 15.1 minutes. Preoperative neuropraxia was associated with an overall increase in the surgery duration (p < 0.017). Bivariate binary regression analysis showed a significant correlation between the increase of surgery duration and flexion-type fracture (odds ratio = 11, p < 0.038) as well as ORIF (odds ratio = 26.2, p < 0.001).

Conclusion Preoperative neuropraxia and flexion-type fractures convey a potential longer surgical duration in pediatric supracondylar fracture.

Level of Evidence Prognostic III.

Keywords

child - supracondylar humeral fractures - recovery of function - prognosis - K-wires

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. IRB [H1RE-22-Dec20–01] granted from the Institutional Review Board in King Saud Medical City, Riyad, Saudi Arabia. IRB registration number with KACST, KSA: H-01-R-053. IRB registration number U.S. Department of HHS IORG: IORG0010374.


Informed Consent

Informed consent was waived by the institutional review board committee due to the nature of the study.




Publication History

Received: 14 May 2023

Accepted: 05 June 2023

Article published online:
03 July 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Georg Thieme Verlag KG
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