Intrainstitutional Changes of the Treatment of Supracondylar Humerus Fracture in Children over a Period of 9 Years
Ferdinand Wagner,
Amalia Boeriu,
Pascal Eberz,
Annabelle Weigert,
Boris Michael Holzapfel,
Wolfgang Böcker,
Jochen Hubertus,
Oliver Muensterer,
Florian Bergmann,
Christian Max Ziegler
Affiliations
Ferdinand Wagner
Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, Ludwig-Maximilians-Universität München, Marchioninistrasse 15, 81377 Munich, Germany
Amalia Boeriu
Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, Ludwig-Maximilians-Universität München, Marchioninistrasse 15, 81377 Munich, Germany
Pascal Eberz
Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, Ludwig-Maximilians-Universität München, Marchioninistrasse 15, 81377 Munich, Germany
Annabelle Weigert
Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, Ludwig-Maximilians-Universität München, Marchioninistrasse 15, 81377 Munich, Germany
Boris Michael Holzapfel
Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, Ludwig-Maximilians-Universität München, Marchioninistrasse 15, 81377 Munich, Germany
Wolfgang Böcker
Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, Ludwig-Maximilians-Universität München, Marchioninistrasse 15, 81377 Munich, Germany
Jochen Hubertus
Department of Pediatric Surgery, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-Universität München, Lindwurmstrasse 4, 80337 Munich, Germany
Oliver Muensterer
Department of Pediatric Surgery, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-Universität München, Lindwurmstrasse 4, 80337 Munich, Germany
Florian Bergmann
Department of Pediatric Surgery, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-Universität München, Lindwurmstrasse 4, 80337 Munich, Germany
Christian Max Ziegler
Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, Ludwig-Maximilians-Universität München, Marchioninistrasse 15, 81377 Munich, Germany
To assess changes in treatment modalities for supracondylar humerus fractures (SCHFs) at a large pediatric university hospital, we analyzed patient data from 2014 to 2022. A total of 233 SCHFs treated surgically at our hospital were included. To evaluate postoperative outcome and quality of life, DASH and EuroQol-5D-Y questionnaires were sent to patients. In addition to a significant fluctuation in fracture severity, we found an increase in training interventions (more surgeries were performed by trainees) and a significant decrease in surgery times after 2016. From 2020, there was a significant shift in the type of surgical method away from closed reduction with elastic stable intramedullary nailing (ESIN) and towards closed reduction and crossed K-wire osteosynthesis (CRK). Surgeries performed in the morning and evening hours increased, while those performed in the afternoon and after midnight decreased. After a mean follow-up of 4 years, there was no difference in elbow function between ESIN and open reduction and K-wires (ORK). Treatment with ESIN was equivalent to ORK in terms of function, at least in the medium-term follow-up. In summary, the combination of shifting treatment from SCHF to daytime hours, increasing trainee participation and using cross K-wire fixation instead of ESIN had no negative impact on surgery times. In our setting, these measures have reduced resource utilization and increased efficiency without compromising patient care.