Analysis of factors leading to open surgery in pediatric supracondylar humeral fractures: A retrospective study

Objectives: Supracondylar humeral fractures (SHFs) are common pediatric injuries, and treatment approaches are largely based on fracture severity and patient-specific factors. Identifying predictors for unsuccessful closed reduction can enhance management strategies. Methods: This retrospective study analyzed 92 pediatric patients with Gartland type III and IV SHFs treated with K-wire fixation at a tertiary center from 2012 to 2023, examining data on demographics, injury characteristics, radiographic parameters, and surgical outcomes. Results: Logistic regression revealed that severe displacement on initial radiograph and age under 8 years were significant predictors of the need for open reduction, with odds ratios of 9.12 and 6.36, respectively. Causes of failed closed reduction included soft tissue interposition and unstable fracture patterns. Conclusion: Supracondylar fractures with severe displacement and age younger than 8 years are key risk factors for requiring open surgical intervention in our study; recognizing these predictors can aid preoperative planning and resident training, despite some study limitations.