Our daughter had a badly displaced fracture of the long arm bone just above the elbow that was not treated for a full 24 hours. She was at a summer camp when it happened. By the time they got her to the nearest local hospital, six hours had passed. There was no doctor available that day so we had to drive there and back to a larger medical center. All together, it was a full day before she was finally in the operating room and getting the fracture pinned. Do you think this is going to affect the results?

Evidently not according to a recent study from UCLA Orthopaedic Hospital in California. They compared this exact type of fracture in two groups of children — those whose treatment was delivered within eight hours against those who had the necessary surgery at least 21 hours later.

They used a variety of ways to compare results: elbow motion, rate and type of complications, and carrying angle of the elbow (a sign of deformity from poor bone healing). Patient and family satisfaction were also measured. In all ways, the results were the same between the two groups. Only when loss of blood or nerve damage were present at the time of injury (before surgery) was there an alarm sounded and the time of surgery pushed up immediately.

But as with your situation, there are times when delays are unavoidable. Sometimes there just isn’t an orthopedic surgeon available to evaluate and treat that child. The family may have to travel to another hospital or clinic where a physician is on-site. In other situations, the hospital’s operating rooms are full. That means another delay in getting proper care for the fracture.

As the results of this one study show, delay in pinning displaced fractures of the supracondylar humerus (at the bottom of the upper arm bone above the elbow) can be done safely and without adverse outcomes. Of course, delays are always to be avoided whenever possible and each child should have treatment based on his or her individual needs. Any child with displaced supracondylar humeral fractures having extreme pain, loss of blood flow, and/or loss of sensation must be treated absolutely as soon as possible. Delayed treatment is not acceptable in this group.