Shortterm outcomes of supracondylar fractures of humerus and their associated factors in children managed at Mulago National Refferal Hospital

Abstract

Background: Supracondylar fractures (SCF) of the humerus is one of the commonest global health concerns among children and need a rigorous management process in order to get satisfactory outcomes. In ensuring so, it is important to use systematic guidelines to aid abate bad events such as vascular complications, malunion and /or elbow stiffness, and amongst others. Main Objective: To describe and analyze outcome of the management of SCF of humerus and their associated factors in children at MNRH at 6 months. Study Methodology: This was a cross-sectional study conducted from May 2020 to November 2020. It consecutively enrolled 77 children with supracondylar fractures of the humerus who were managed at Mulago National Referral Hospital. Their contact information was retrieved from the records department. Using Flynn’s criteria, current flexion and extension at the elbow joints, and humeroulnar angle were assessed and compared to the contralateral limb to get the functional and radiological outcomes at 6 months. We used bivariate and multivariate analysis to find out the associated factors. Results: The mean age was 7.86 years. Males were more affected. About 94% of the patients had a healthy BMI. Majority of the patients (58.44%) presented to the hospital for treatment, three or more days after the injury. Left upper limb was affected mostly and it was the nondominant hand in most of the patients. Gartland type I fracture constituted 55.84%, followed by type II 29.87% and then type III were 14.29%. Majority of the patients (88.31%) were managed non-operatively while 11.69% were managed operatively. The satisfactory functional outcome was 47% and the unsatisfactory functional outcome constituted 53%. Around 82% of the patients had a satisfactory radiological outcome. In this study, delay in seeking treatment, type of the fracture and duration of immobilization were statistically significant (P-value less than 0.05) with the above results. Conclusion The short-term functional outcome of SCF of the humerus was generally not good, but a satisfactory radiological outcome was found in a great majority of the patients. We clearly demonstrated that duration of immobilization, type of the fracture and seeking late medical care had a negative impact to the outcome of these fractures.