25dkou358 10.3205/25dkou358 urn:nbn:de:0183-25dkou3586 Meeting Abstract Maharjan Maharjan Rajiv R

BP Koirala Institute of Health Sciences, Dharan, Nepal

author Magar Magar Sagar S

BP Koirala Institute of Health Sciences, Dharan, Nepal

author Gurung Gurung Yam Y

BP Koirala Institute of Health Sciences, Dharan, Nepal

author Shah Shah Jitendra J

BP Koirala Institute of Health Sciences, Dharan, Nepal

author Chaudhary Chaudhary Pashupati P

BP Koirala Institute of Health Sciences, Dharan, Nepal

author German Medical Science GMS Publishing House

Düsseldorf

610 Gartland type III supracondylar fracture Open Reduction and Internal Fixation (ORIF) closed reduction predictors Body Mass Index (BMI) paediatric fractures 20251031 engl This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). M0634 358 Deutsche Gesellschaft für Orthopädie und Unfallchirurgie Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie Deutsche Gesellschaft für Unfallchirurgie Berufsverband für Orthopädie und Unfallchirurgie Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2025) Abstracts | Kinderorthopädie Berlin 20251028 20251031 AB54-4532 TextObjectives and questions: Supracondylar fractures of the humerus are the most common paediatric elbow fractures, with Gartland Type III fractures posing significant challenges due to a higher likelihood of closed reduction failure. Identifying predictive factors for failure can aid in appropriate counselling of the patient and parents, better surgical planning and improving patient outcomes.Material and methods: This descriptive cross-sectional study was conducted over 12 months at a level I tertiary care centre and university based academic institution. 50 children with closed Gartland Type III supracondylar fractures of humerus without neurovascular deficit and presenting within 7 days of injury were enrolled. Demographic, clinical and radiographic variables were analysed, including age, Body Mass Index (BMI), injury-to-reduction time, fracture displacement and presence of gross swelling. All cases initially underwent closed reduction and percutaneous pinning (CRPP) with Kirschner wire (K-wire) in elective basis under general anaesthesia. Open reduction and internal fixation (ORIF) was performed for failed closed reductions. Bivariate analyses were performed to determine the significant risk factors for failure of closed reduction while multivariate logistic regression was done to find the strength of prediction (Odds ratio) for those variables.Results: Overall, closed reduction was successful in 64% of cases, while 36% required ORIF. The bivariate analysis identified high BMI, displacement >4 mm, swelling, and delayed injury-to-reduction time as significant risk factors for CRPP failure. Multivariate logistic regression revealed that an injury-to-reduction time beyond three days was the most predictive factor for CRPP failure (aOR: 11.08, 95% CI: 1.69–7.27) followed by time of presentation (OR: 10.36, 95% CI: 0.51–20.93) and presence of swelling (OR: 4.68, 95% CI: 0.67–7.74).Discussion and conclusions: Delay in injury-to-reduction time, high BMI, and greater displacement significantly increase the risk of closed reduction failure in Gartland Type III supracondylar fractures. Early surgical intervention and careful preoperative evaluation of risk factors are essential to improve outcomes by proper counselling and planning of surgery. 0 0 0 0