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Pediatric Supracondylar Humeral Fractures: Epidemiology and Mechanisms of Injury During the Covid-19 PandemicDuring Pandemic

Abstract

Background: The purpose of this study is to evaluate the impact of the Covid-19 pandemic on activity restrictions in pediatric supracondylar humerus fractures in terms of both mechanism of injury and fracture patterns. Methods: This is a retrospective chart review of all patients presenting with types II-IV supracondylar humerus fractures during the Covid-19 pandemic compared to a non-pandemic cohort. Results: A total of 40 patients were included in the pandemic group with a mean age of 5.7 years, and 35 patients in the non-pandemic group with a mean age of 5.9 years. In the pandemic group, 5 (13.0%) fractures were graded as 2A, 15 (38.0%) were graded as 2B, 18 (45.0%) as grade 3, and 2 (5.0%) as flexion type. In the non-pandemic group, 8 (23.0%) fractures were graded as 2A, 10 (29.0%) were graded as 2B, 16 (46.0%) as grade 3, and 1 (3.0%) as flexion type. Furthermore, 11 fractures (28.0%) in the pandemic group were classified as having medial collapse while 5 (14.0%) fractures in the non-pandemic group presented with medial collapse. The most common mechanism of injury in the pandemic group was falling off furniture with 9 injuries (23.0%), and in the non-pandemic group was fall off monkey bars in 8 (23.0%) patients. Conclusion: This study demonstrated a higher rate of serious fracture patterns with the presence of medial comminution in the pandemic group. The mechanism of injury differs from the non-pandemic group with most fractures occurring in an indoor as opposed to outdoor setting.

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