Clinical Auditing on Rehabilitation of Supracondylar Fracture of Humerus among Children at a Tertiary Care Hospital

Abstract

Background: Supracondylar Humeral Fractures in Children (SCFH) are one of the most common paediatric fractures. This study evaluated the impact of exercise compliance on functional outcomes in patients following the removal of casts and Kwires who were treated either conservatively or with closed reduction and fixation, respectively. Materials and methods: This observational study at Chattagram Maa-Shishu O General Hospital (July 2023–June 2024) included 100 children (2–14 years) with SCFH treated by casting or CRIF. The purposive sampling technique was used. Data were collected via a pretested semi-structured questionnaire and analyzed using SPSS version 26.0. ROM was assessed post-treatment using Flynn's criteria at 2, 4 and 6 weeks, comparing outcomes between adherent and non-adherent exercise groups. Results: Among the patients, 64% were male and 36% female. Most were aged 2–9 years (91%) notably 4–6 years (34%) and 2–3 years (32%). Adherent patients who exercised had significantly better ROM outcomes than non-adherent ones. In the CRIF group, 84.2% of adherent patients achieved good ROM versus 15.0% of nonadherent. In the cast group, 80.6% of adherent patients achieved good ROM versus 10.7% of non-adherent. Non-adherence increased the odds of poor outcomes by 28.7 times in the cast group (p=0.001) and 25.1 times in the CRIF group (p=0.03). Key barriers to follow-up were financial issues (60%) and lack of awareness (40%). Conclusion: Compliance with exercise is a major determinant of functional outcome following SCFH treatment in children regardless of treatment technique. The stark contrast in outcomes between compliant and non-compliant patients highlights the need for standardized rehabilitation protocols, like collaborative interventions between musculoskeletal or orthopaedics physiotherapists and orthopedic surgeons, to improve exercise compliance in pediatric orthopedic care.

Chatt Maa Shi Hosp Med Coll J; Vol.25 (1); January 2026; Page 41-47