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Epidemiology of Vascular Complications in Supracondylar Humerus Fractures in the United States
Charles T. Mehlman, DO, MPH, Cincinnati Children's Hospital Medical Center, Cincinnati OH

Abstract:
Objective The purpose of our research was to analyze the incidence of vascular complications associated with pediatric supracondylar humeral fractures in the United States using the KID (Kid's Inpatient Database from the Healthcare Cost and Utilization Project) 1997 thru 2006. Methods ICD-9 codes were used to identify variables of interest within the KID database. Our variables of interest included primary outcome measures (compartment syndrome, injury to the brachial artery, brachial artery thrombosis, and Volkmann's contracture) and potential risk factors associated with vascular complications (presence of concomitant fractures, concomitant nerve injury, presence of an open fracture, age, gender, geographic location, and hospital type). Results: Among the 39,672 patients with a supracondylar humerus fracture, 130 developed compartment syndrome and 243 sustained a brachial artery injury, yielding incidence rates of 0.33% and 0.61% respectively. Conclusion: Our large database study confirms supracondylar humeral fracture patients who have concomitant upper extremity fractures or nerve injury have a higher risk of vascular injury. Our study is also the first to report the national incidence of brachial artery injury (approximately 60 children per year in the USA) and compartment syndrome (approximately 32 children per year in the USA) in pediatric supracondylar humeral fracture patients.
Objective:
Demonstrate
Objective Content: This study should inspire us to engage in quality improvement efforts aimed at mitigating vascular complications associated with these fractures.


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