The Effect of Weather Conditions on Pediatric Supracondylar Humerus Fractures

Background: Environmental conditions are effective on childhood supracondylar humerus fractures. In this study, we evaluated the relationship between weather conditions and these fractures. Materials and Methods: We started this study following the approval of a non-interventional research ethics committee. Patients (<16 years) who applied to the hospital between January 2013 and July 2018 with supracondylar humerus fractures were included in the study. The hospital’s PROBEL system was used to diagnose (International Classification of the Diseases, ICD, S42.4) radiological images and patient information. Information on the weather conditions in the day and time period, in which supracondylar humerus fracture occurred, was obtained from TR (Turkey) Ministry of Agriculture and Forestry General Directorate of Meteorology. The relationship between supracondylar fracture and daily weather conditions (wind, air temperature, cloudiness, and season) was analyzed. Results: Most of the patients (n = 76, 40.6%, p < 0.05) were fractures occurring under cloudless weather conditions. Fractures were concentrated with a second frequency in cloudy weather over 60%, except for cloudless weather conditions (n = 51, 27.3%, p < 0.05). In the summer months when the air temperature was high, the number of fractures was higher (n = 62, 33.2%, p < 0.05) and less in the winter months (n = 24, 12.8%, p < 0.05). In hot weather conditions where the daily average temperature was above 20°C, supracondylar humerus fractures were observed more (n = 101, 54%) and less than 10°C (n = 43, 23%, p < 0.05). Increased incidence of fractures was observed in the presence of wind (n = 4, 2.1%, p < 0.05). Conclusion: Supracondylar humerus fractures are common in children. Environmental conditions (temperature, wind, and season) can be effective in the occurrence of these fractures.

Complex open elbow fracture Gustilo-Anderson type IIIB treated with the primary elbow arthroplasty: A case report

Total elbow arthroplasty as a treatment option for open elbow fracture is relatively rare described.We reported a 39 years old polytrauma patient with complex open elbow fracture(Gustilo-Anderson type IIIB).The patient presented with large soft tissues defect on dorsal part of the left elbow,ulnar palsy due to the irreparable loss of the ulnar nerve,distal triceps loss due to the complete loss of the olecranon,loss of both humeral condyles with collateral ligaments and complex elbow instability.Only few similar cases have been published.Reconstructive surgery included repetitive radical debridement,irrigation,vacuum assisted closure system therapy,external fixation,coverage of the soft tissue defect with fascia ecutaneous flap from the forearm.Four months after the injury,total elbow arthroplasty with autologous bone graft(from the proximal radius)inserted in the ulnar component,was performed.At 3 years postoperatively,the patient is able to perform an active flexion from 0to 110with full pronosupination.Only passive extension is allowed.The ulnar neuropathy is persistent.Patient has no signs of infection or loosening of the prosthesis.