Socioeconomic disadvantage predicts poorer functional recovery after non-operative treatment of paediatric supracondylar humerus fractures.

PURPOSE: Supracondylar humerus fractures are the most common elbow injuries in children, with non-operative management frequently preferred in Gartland type I and selected type II cases. While biomechanical factors affecting outcomes have been well documented, the influence of socioeconomic status (SES) on functional and radiological results remains insufficiently explored.

METHODS

This retrospective cohort study analyzed 237 children (aged 3-13 years) treated non-operatively for supracondylar humerus fractures between February 2019 and February 2024. Socioeconomic status was determined using the Hollingshead Index and categorized as low, middle, or high. Functional outcomes were assessed using Flynn's criteria, while radiological evaluation included Baumann and carrying angle measurements. Subgroup analyses were performed according to fracture type.

RESULTS

There were no significant differences in age, gender, or fracture type between SES groups (p > 0.05). However, Flynn functional scores were significantly lower in the low-SES group compared with middle- and high-SES groups (p = 0.014). Radiological parameters, including Baumann and lateral humerocapitellar angles, did not differ significantly among groups (p = 0.41 and p = 0.37, respectively). Complications were rare (2.3%) and similar between groups.

CONCLUSION

Socioeconomic disadvantage was associated with poorer functional recovery after non-operative management of paediatric supracondylar humerus fractures, despite comparable fracture characteristics and radiological results. Early follow-up and caregiver support may help mitigate these disparities.

LEVEL OF EVIDENCE: Level III (retrospective cohort study).