The effect of surgical timing on the perioperative complications of treatment of supracondylar humeral fractures in children

Background: The purpose of this study was to evaluate the perioperative com plication rates associated with early surgical treatment (eight hours or le ss following injury) and delayed surgical treatment (more than eight hours following injury) of displaced supracondylar humeral fractures in children. Methods: Fifty-two patients had early surgical treatment and 146 patients h ad delayed surgical treatment of a displaced supracondylar humeral fracture . The perioperative complication rates of the two groups were compared with the use of bivariate and multivariate statistical methods. Results: There was no significant difference between the two groups with re spect to the need for conversion to formal open reduction and internal fixa tion (p = 0.56), pin-track infection (p = 0.12), or iatrogenic nerve injury (p = 0.72). No compartment syndromes occurred in either group. Power analy sis revealed that our study had an 86% power to detect a 20% difference bet ween the two groups if one existed. Conclusions: We were unable to identify any significant difference, with re gard to perioperative complication rates, between early and delayed treatme nt of displaced supracondylar humeral fractures. Within the parameters outl ined in our study, we think that the timing of surgical intervention can be either early or delayed as deemed appropriate by the surgeon.