Epidemiological Analysis of Elbow Fractures in Children of Urban Populations of the Third World Country

Ghazanfar Ali Ali Shah; Mukesh Kumar; M. Sabir Memon; Affan Tayyab; Syed Muhammad Sibtain; Imran Khan Mangi

doi:10.46663/ajsmu.v11i2.57-61

Ghazanfar Ali Ali Shah Consultant Orthopaedic Surgeon, Department of Orthopaedic Surgery, Shaheed Mohtarma Benazir Bhutto Institute of Trauma, (SMBBIT), Karachi, Pakistan
Mukesh Kumar Senior Registrar Orthopaedic Surgery, Shaheed Mohtarma Benazir Bhutto Institute of Trauma, (SMBBIT), Karachi, Pakistan
M. Sabir Memon Chief Orthopaedic Surgeon & Executive Director, Shaheed Mohtarma Benazir Bhutto Institute of Trauma, (SMBBIT), Karachi, Pakistan
Affan Tayyab Fellow Orthopaedic Surgery, Shaheed Mohtarma Benazir Bhutto Institute of Trauma, (SMBBIT), Karachi, Pakistan
Syed Muhammad Sibtain Registrar Orthopaedic Surgeon, Shaheed Mohtarma Benazir Bhutto Institute of Trauma, (SMBBIT), Karachi, Pakistan
Imran Khan Mangi Registrar, Shaheed Mohtarma Benazir Bhutto Institute of Trauma, (SMBBIT), Karachi, Pakistan

DOI: https://doi.org/10.46663/ajsmu.v11i2.57-61

Keywords: Bone-setter, Child, Elbow injuries, Epidemiology, Fractures, Orthopedic Procedures, Pakistan, Retrospective Studies, Traditional Medicine

Abstract

Objective:

To evaluate the demographic patterns, injury mechanisms, fracture distribution, factors associated with delayed presentation, in children presenting with elbow fractures at a tertiary trauma center of Karachi.

Methodology:

This retrospective cross-sectional study was conducted at the department of orthopedic surgery SMBBIT Karachi from January 2022 to March 2024. All Pediatric patients (<14 years) with radiologically confirmed elbow fractures requiring surgical intervention were included. The variables analyzed in this study included age, sex, injury mechanism, fracture type, laterality, bonesetter contact, time to presentation, swelling, neurovascular status, and treatment modality. Fisher’s exact test assessed associations between bonesetter visits, delay, and swelling.

Results:

A total of 180 patients with mean age 7.2 ± 3.6 years were included. Supracondylar fractures accounted for 73% of cases, predominantly affecting males (69.5%) and with left side (66.7%). The most common mechanism of injury falls during play (53.9%). Those patients who presented after 24 hours had prior visit to bonesetters and were all associated with significant swelling at presentation, and its association is confirmed with Fisher’s test OR ~ 3.8, p < 0.001). In children presented with RTA about 2.8% had vascular injuries. The most frequently performed procedure was close reduction and percutaneous pinning (CRPP), followed by open reduction and internal fixation (ORIF), accounting for 60% and 35% of the cases, respectively.

Conclusion:

The most common elbow fracture among children in Karachi was the supracondylar fracture. Delay in presentation was mainly due to initial consultations with bonesetters, which is a preventable factor that can be addressed through public awareness and early referral to reduce complications associated with this disabling condition.

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