![]() There was no association between fractured arm appearance at follow-up and PRO scores. No other preoperative or postoperative radiographic parameter was significantly associated with PRO scores. It is unknown if this statistical difference translates to clinical relevance. Patients with Gartland type-III fractures had significantly greater disability on the QuickDASH at follow-up compared with those with Gartland type-II fractures ( P < .01). Bivariate analysis was used to determine whether radiographic parameters and arm appearance were associated with QuickDASH and PROMIS scores. ![]() Anterior humeral line through the capitellum, Baumann angle in the 7.5th to 92.5th percentile of the sample, or rotation ratio between 0.85 and 1.15 were considered near complete/complete reductions all others were considered incomplete. We evaluated postoperative radiographs for coronal/sagittal deformity, Baumann angle, and rotation and classified reductions as near complete/complete or incomplete. Parents were also asked whether the previously fractured arm appeared normal or abnormal. Patients, parents were asked via telephone to complete the QuickDASH (Quick Disability of the Arm, Shoulder, and Hand) and PROMIS (Patient-Reported Outcomes Measurement Information System) Strength Impact, Upper Extremity, and Pain Interference questionnaires. We evaluated preoperative radiographs for coronal/sagittal fracture displacement, presence of impaction/comminution, Gartland classification, and rotation. Mean time from initial treatment to outcome survey completion was 5.0 ± 2.1 years (range, 2.0–10 years). Mean (± standard deviation) age at surgery was 5.1 ± 2.1 years. We retrospectively reviewed data from 213 patients (104 girls) treated surgically for Gartland type-II (n = 84) or type-III (n = 129) SCH fractures from 2008–2016. We studied whether such parameters are correlated with mid-term patient-reported outcome (PRO) scores in pediatric patients. A high index of suspicion should be maintained for compartment syndrome of the arm as well as the forearm when evaluating children with severe supracondylar humerus fractures.Radiographic parameters are commonly used to determine the need for surgical supracondylar humeral (SCH) fracture reduction and the postoperative quality of reduction. Ultimately, muscle tenderness and compartment pressure measurement were most helpful in making this diagnosis. The presence of the associated fracture made the classic signs of compartment syndrome difficult to assess. This is the first report of a compartment syndrome of the arm after an isolated supracondylar humerus fracture in a child. An urgent compartment release of the arm was done, which resulted in full recovery. These confirmed a compartment syndrome in the anterior compartment of the arm and equivocally in the mobile wad. Over the next day, he developed considerable tenderness over the anterior arm and mobile wad musculature, hence, compartment pressure measurements were made. He was observed as an inpatient because of this persistent swelling. Although significant swelling was noted at that time, compartment syndrome was not clinically suspected. Eleven hours after the injury, a routine closed reduction and percutaneous pinning was performed. Because of the severity of the deformity, a provisional reduction was performed in the emergency department. This patient sustained a closed supracondylar humerus fracture in association with a motor and sensory deficit of the radial nerve. A clinical, radiographic, and literature review of this case was undertaken to better define this occurrence. ![]() Compartment syndrome of the upper arm is an even more rare occurrence and to date, has not been reported in association with an isolated supracondylar humerus fracture in a child.Ī 9-year-old boy was cared for at our facility for a severe (Gartland type III) supracondylar humerus fracture and developed a compartment syndrome in the perioperative period. One of the most feared complications of this fracture, that is, compartment syndrome of the forearm is seen rarely. Supracondylar fractures of the humerus are the most frequently seen elbow fractures in children. ![]()
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