The Impact of Surgical Timing on Complications and Clinical Outcomes in Surgery for Displaced Pediatric Supracondylar Humerus Fracture.

Background: Pediatric supracondylar humerus fractures are common in children aged 5-7. The mechanism of injury, fracture type, and its relationship to the epiphysis significantly affect long-term outcomes. This study examines the impact of demographic data, fracture characteristics, and surgical timing and duration on postoperative results.

Material and methods: Patients treated for supracondylar humerus fractures between February 2009 and January 2021 were included. Pre- and postoperative radiographs were analyzed, and surgical timing and duration were compared with fracture type and clinical outcomes.

Results: A total of 121 patients (72 males, 49 females) at a mean age of 6.6 2.8 years were evaluated. The mean surgery duration was 50.1 29.2 minutes. Fractures were classified as Gartland type 2a (38 patients), type 2b (59 patients), and type 3 (24 patients). Closed reduction with percutaneous pinning was performed in 82 cases. Complications occurred in 7 patients with surgery delays of less than 8 hours and in 4 patients with delays over 8 hours. A significant correlation was found between surgical timing, hospital stay, and complications (p<0.05). The Flynn criteria indicated better outcomes in patients with surgery performed between midnight and 08 a.m. and within 8 hours of injury.

Conclusions: 1. Pediatric patients operated on during nighttime hours exhibited higher complication rates and longer hospital stays. 2. Outcomes assessed using the Flynn criteria were superior in patients operated on during daytime hours or with surgical waiting times of less than 8 hours. 3. These findings suggest that there is no universal definitive limit for optimal surgical timing. 4. Patient-specific conditions and clinical features should guide surgeons in determining the appropriate timing for surgery.