Epidemiologic investigation of pediatric distal humerus fractures: An American insurance claims database study

World J Orthop. 2024 Jan 18;15(1):52-60. doi: 10.5312/wjo.v15.i1.52.

Abstract

Background: Distal humerus elbow fractures are one of the most common traumatic fractures seen in pediatric patients and present as three main types: Supracondylar (SC), lateral condyle (LC), and medial epicondyle (ME) fractures.

Aim: To evaluate the epidemiology of pediatric distal humerus fractures (SC, LC, and ME) from an American insurance claims database.

Methods: A retrospective review was performed on patients 17 years and younger with the ICD 9 and 10 codes for SC, LC and ME fractures based on the IBM Truven MarketScan® Commercial and IBM Truven MarketScan Medicare Supplemental databases. Patients from 2015 to 2020 were queried for treatments, patient age, sex, length of hospitalization, and comorbidities.

Results: A total of 1133 SC, 154 LC, and 124 ME fractures were identified. SC fractures had the highest percentage of operation at 83%, followed by LC (78%) and ME fractures (41%). Male patients were, on average, older than female patients for both SC and ME fractures.

Conclusion: In the insurance claims databases used, SC fractures were the most reported, followed by LC fractures, and finally ME fractures. Age was identified to be a factor for how a pediatric distal humerus fractures, with patients with SC and LC fractures being younger than those with ME fractures. The peak age per injury per sex was similar to reported historic central tendencies, despite reported trends for younger physiologic development.

Keywords: Epidemiology; Lateral condyle fracture; Medial epicondyle fracture; Pediatric elbow; Supracondylar humerus fracture; Truven.