Şahan GÜVEN, Enejd VEIZI, Ali Said NAZLIGÜL, Aras PERVANE, Nevzat ARICAN, İzzet BİNGÖL
Anatolian Current Medical Journal - 2026;8(1):123-129
Aims: The aim of this study was to evaluate the relationship between familial social deprivation and postoperative outcomes in pediatric patients who underwent surgical treatment for supracondylar humerus fractures. Methods: This retrospective cohort study included 153 children (aged 3-13 years) who underwent operative fixation for supracondylar humerus fractures between February 2019 and April 2024. Patients were divided into two groups according to the Évaluation de la Précarité et des Inégalités de Santé pour les Centres d'Examens de Santé (EPICES) score: socially deprived (EPICES >=30) and non-deprived (EPICES <30). Exclusion criteria included open fractures, delayed surgery (>4 days), inadequate follow-up, neurovascular exploration, previous ipsilateral elbow fracture, and floating elbow injury. All patients were treated by closed or open reduction and percutaneous pinning with two lateral and one medial K-wire. Postoperative outcomes were evaluated using Flynn's criteria, Baumann angle, and lateral humerocapitellar angle (LHCA). Group comparisons were made using chi-square, independent t, and Mann-Whitney U tests, with a significance threshold of p<0.05. Results: Of the 153 patients, 71 were non-deprived and 82 were socially deprived. Demographic variables (age, sex, fracture type, and time to surgery) were comparable between groups (p>0.05). Radiological parameters, including Baumann angle (72.2 derece+/-8.3 vs. 71.2 derece+/-8.8, p=0.512) and LHCA (32.7 derece+/-9.7 vs. 32.4 derece+/-8.9, p=0.927), showed no significant differences. However, Flynn's functional factor scores were poorer in the socially deprived group (3.0+/-2.4 vs. 2.3+/-2.0, p=0.096), and cosmetic factor scores were significantly worse (4.7+/-2.9 vs. 3.5+/-2.7, p=0.009). Subgroup analysis revealed that this difference was more pronounced in patients treated with closed reduction and internal fixation (p=0.024 for Flynn index; p=0.008 for functional factor). Post-hoc power analysis confirmed an adequate study power (0.83-0.94). Conclusion: Social deprivation was associated with poorer functional and cosmetic outcomes after surgical treatment of pediatric supracondylar humerus fractures, despite similar radiological results. These findings indicate that socioeconomic factors may influence recovery independent of surgical technique and underscore the importance of strengthened follow-up support for disadvantaged families.
