{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T12:56:08Z","timestamp":1792760168425,"version":"4.5.0"},"reference-count":24,"publisher":"British Editorial Society of Bone & Joint Surgery","issue":"9","license":[{"start":{"date-parts":[[2013,9,1]],"date-time":"2013-09-01T00:00:00Z","timestamp":1377993600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/online.boneandjoint.org.uk\/TDM"}],"content-domain":{"domain":["online.boneandjoint.org.uk"],"crossmark-restriction":true},"short-container-title":["The Bone &amp; Joint Journal"],"published-print":{"date-parts":[[2013,9]]},"abstract":"<jats:p>Supracondylar humeral fractures are common in children, but there are no classification systems or radiological parameters that predict the likelihood of having to perform an open reduction. In a retrospective case\u2013control study we evaluated the use of the medial spike angle and fracture tip\u2013skin distance to predict the mode of reduction (closed or open) and the operating time in fractures with posterolateral displacement. A total of 21 patients (4.35%) with a small medial spike angle (&lt; 45\u00b0) were identified from a total of 494 patients, and 42 patients with a medial spike angle of &gt; 45\u00b0 were randomly selected as controls. The medial spike group had significantly smaller fracture tip\u2013skin distances (p &lt; 0.001), longer operating times (p = 0.004) and more complications (p = 0.033) than the control group. There was no significant difference in the mode of reduction and a composite outcome measure. After adjustments for age and gender, only fracture tip\u2013skin distance remained significantly associated with the operating time (\u03b2 = -0.724, p = 0.042) and composite outcome (OR 0.863 (95% confidence interval 0.746 to 0.998); p = 0.048).<\/jats:p><jats:p>Paediatric orthopaedic surgeons should have a lower threshold for open reduction when treating patients with a small medial spike angle and a small fracture tip\u2013skin distance.<\/jats:p><jats:p>Cite this article: Bone Joint J 2013;95-B:1290\u20134.<\/jats:p>","DOI":"10.1302\/0301-620x.95b9.31683","type":"journal-article","created":{"date-parts":[[2013,8,30]],"date-time":"2013-08-30T14:20:22Z","timestamp":1377872422000},"page":"1290-1294","update-policy":"https:\/\/doi.org\/10.1302\/crossmark-policy","source":"Crossref","is-referenced-by-count":20,"title":["Supracondylar humeral fractures in children"],"prefix":"10.1302","volume":"95-B","author":[{"given":"K. B. L.","family":"Lim","sequence":"first","affiliation":[{"name":"KK Women\u2019s & Children\u2019s Hospital, Division of Surgery, 100 Bukit Timah Road, 229899, Singapore."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. T.","family":"Lim","sequence":"additional","affiliation":[{"name":"National University of Singapore, Department of Orthopaedic Surgery, National University Health System, Singapore."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. K.","family":"Tawng","sequence":"additional","affiliation":[{"name":"KK Women\u2019s & Children\u2019s Hospital, Department of Orthopaedic Surgery, 100 Bukit Timah Road, 229899, Singapore."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"42","reference":[{"key":"r1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.G.01354"},{"key":"r2","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3468(72)90278-3"},{"key":"r3","unstructured":"Kasser JR, Beaty JH.Supracondylar fractures of the distal humerus. In:Rockwood and Wilkins\u2019 fractures in children. Fifth ed. 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