scholarly journals Operative management of type III extension supracondylar fractures in children

2008 ◽  
Vol 33 (4) ◽  
pp. 1089-1094 ◽  
Author(s):  
Cemal Kazimoglu ◽  
Murat Çetin ◽  
Muhittin Şener ◽  
Haluk Aguş ◽  
Önder Kalanderer
Keyword(s):  
Operative Management ◽  
Supracondylar Fractures ◽  
Type Iii ◽  
Fractures In Children

scholarly journals SUPRA CONDYLAR FRACTURE OF THE HUMERUS IN CHILDREN;

2013 ◽  
Vol 20 (03) ◽  
pp. 456-461
Author(s):  
MOGHEES IKRAM AMEEN ◽  
AQEEL SAFDAR ◽  
FAUZIA MOGHEES
Keyword(s):  
Nerve Palsy ◽  
Neurological Complications ◽  
Late Presentation ◽  
Radial Nerve Palsy ◽  
X Rays ◽  
Supracondylar Fractures ◽  
Post Injury ◽  
Type Iii ◽  
Fractures In Children ◽  
Median Nerve Palsy

Supra condylar fractures in children are a serious injury with a significant morbidity. Setting: CMH Multan. Patients presentvery late, often after being mishandled by traditional bone-setters, with lifelong consequences. All children up to the age of 12 years withsupra condylar humeral fractures presenting to our hospital were included in the study. Careful history and examination was carried outand necessary x-rays were taken. Time since injury, all treatments administered, complications and any other data was recorded. Period:From 1999 to 2004. 304 cases were included in the study. Only 12% patients presented within 24 hours. 87.5% children presented from72 hours to 3 weeks post injury. The reasons recorded were lack of access to proper medical help, illiteracy, poverty and manipulation bytraditional bone setters. Based on Gartland's Classification1 61% patients had un-displaced and 39% had displaced fractures. 61% wereType I fractures, 19% Type II and 20% Type III fractures. Due to late presentation these patients had more complications including myositisossificans, neurological complications and contractures due to tight bandages by traditional health bone setters. Patients with displacedsupracondylar fractures, who present early, usually require manipulation and fixation by percutaneous pinning 2,3,4. In our study,because of very late presentation they could not be treated by closed reduction and 18 %cases with type III fractures were treated by OpenReduction and Internal Fixation. Since they presented very late and had complications like Radial nerve palsy, Median nerve palsy, Ulnar5 nerve palsy , ischemia, Brachial artery compression, Compartment syndrome, Volkmann's ischemic contracture the treatment protocolhad to be changed. Post operative complications in a few patients included Pin tract infection and Elbow stiffness. In most cases full rangeof movement could not be achieved, however functional movement was satisfactory. These resulted in less patient satisfaction andlifelong consequences. To conclude our study shows that due to very late presentation of supracondylar fractures of the humerus inchildren different management protocols have to be made, tailored to individual needs of the patient.

scholarly journals Does the timing of surgery affect outcomes of gartland type III supracondylar fractures in children?

2019 ◽  
Vol 7 (2) ◽  
pp. 25-32
Author(s):  
Hyun-Chul Shon ◽  
Ji Wan Kim ◽  
Hun-Kyu Shin ◽  
Eugene Kim ◽  
Se-Jin Park ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Clinical Outcomes ◽  
Operation Time ◽  
Timing Of Surgery ◽  
Bone Union ◽  
Supracondylar Fractures ◽  
Type Iii ◽  
Fractures In Children ◽  
Pin Fixation ◽  
Supracondylar Humerus Fractures

Background. Gartland type III supracondylar fractures in children are treated as emergency. But there are few studies about surgical timing and clinical outcomes. Aim. To evaluate whether the time interval from injury to surgical treatment affects the treatment outcomes of Gartland type III supracondylar fractures in children. Methods. The study population comprised all children presenting to our hospital between April 2003 and December 2013, who had Gartland type III supracondylar humerus fracture. Patients were divided into three groups: those who were treated within less than six hours from injury, those who were treated between six and twelve hours, and those who were treated between twelve and twenty four hours after injury. In this retrospective study, we checked whether the timing of surgery affected clinical outcomes such as bone union, range of motion, peri-operative complications, and operation time. Results. All patients were treated with closed reduction and percutaneous pin fixation within 24 hours. This study showed a trend that the delay in the timing of surgery after traumatic injury increases operation time, however with no statistical differences. The neurological complications were similar in the three groups. There were 11 cases (14.7%) of preoperative neurologic deficit, however every patient recovered postoperatively. There was no difference between the three groups in terms of clinical outcomes such as range of motion of the elbow and bone union. Conclusion. For Gartland III pediatric supracondylar humerus fractures, operation can be delayed for up to 24 hours, which may allow time for operation during regular hours, rather than late at night, with thorough evaluation of circulation, nerve injury, and swelling.

scholarly journals Open Reduction of Supracondylar Humerus Fractures in Children for Failed Closed Reduction: Outcome of Delayed Treatment

2021 ◽  
Vol 53 (3) ◽  
pp. 143-147
Author(s):  
Yoyos Dias Ismiarto ◽  
◽  
Mahyudin ◽  
Adriel Benedict Haryono
Keyword(s):  
Closed Reduction ◽  
Open Reduction ◽  
Kirschner Wire ◽  
Early Group ◽  
Supracondylar Fractures ◽  
Delayed Treatment ◽  
Type Iii ◽  
Fractures In Children ◽  
Kirschner Wire Fixation ◽  
Supracondylar Humerus Fractures

Supracondylar fractures of the humerus are common in children and the advocated treatments for these fractures include closed reduction and percutaneous pinning. There are numerous debates on the intervention period selection for delayed treatment in children. This phenomenon is prevalent in regions with limited healthcare support. The objective of this study was to compare the outcome of early and late treatment groups, including preliminary presentations and the management of failed treatment. This was a prospective comparative study on early and late open reduction, featuring Kirschner wire fixation for Gartland type III supracondylar fracture of humerus in children aged less than 18 years. Patients from January 2018 to January 2019 were categorized into early and late groups (n=22 and n=26), consisting of 33 (86.8%) males and 15 (31.25%) females. Flynn’s criteria were used to evaluate them. The average time from injury to surgery was 50.24±23.5 hours in the early group and 373.79±89.23 hours in the late group (p<0.002). While the Bauman’s angle recorded after 12 weeks presented the values of 82.04 ± 5.18 and 77.38±6.43 (p=0.622) for the early and late groups, respectively. Pre-operative nerve injuries were observed only in 4 (8.33%) cases from the early group. The functional outcomes of both categories were not significantly different statistically (p=0.242). The outcome for children with supracondylar humerus fracture Gartland type III was satisfactory in both groups. In conclusion, treatment delay does not result in a difference in the outcome according to Flynn's criteria.

Comparison of Outcome of Three Different Approaches for Supracondylar Humerus Fractures in Children

2021 ◽  
Vol 15 (10) ◽  
pp. 3482-3484
Author(s):  
Syed Usman Shah ◽  
Mohammad Younas ◽  
Naseer Ullah Khattak ◽  
Amina Gul Shehzar Khan ◽  
Sultan Shah ◽  
...  
Keyword(s):  
Posterior Approach ◽  
Lateral Approach ◽  
Supracondylar Fractures ◽  
Medial Approach ◽  
Fractures In Children ◽  
Supracondylar Humerus Fractures ◽  
Significant Difference ◽  
Group A ◽  
Humerus Fractures ◽  
Group B

Objective: The aim of this study is compare the outcomes among three different approaches (lateral approach, medial approach and posterior approach) for supracondylar humerus fractures in children. Study Design: Retrospective cohort study Place and Duration: The study was conducted at Orthopedics department of Ayub Teaching Hospital, Abbottabad for duration of one year from January 2020 to December 2020. Methods: There were one hundred and thirty five children had supracondylar humerus fracture were presented. Patients were aged between 3-12 years. Informed written consent was taken from authorities for detailed demographics age, sex, cause of fracture and side of fracture. Patients were categorized into three equal groups, group A had 45 patients and received lateral approach, group B had 45 patients and received medial approach and group C received posterior approach with 45 cases. Shaft Condylar Angle (SCA) and Baumann angle were used to analyze the radiological result. All children were assessed using Flynn's criteria for functional outcomes, and the results were divided into Excellent, Good, Fair and Poor. Post-operative outcomes among all the three groups were calculated and compared. SPSS 23.0 version was used to analyze complete data. Results: There were 90 (66.7%) males (30 in each group and 45 (33.3%) females (15 in each group). In group A mean age was 6.88±5.45 years, mean age in group B was 7.11±5.33 years and in group C mean age was 7.17±5.66 years. Sports 85 (62.9%) was the most common cause of fracture followed by traffic accidents 30 (22.2%) and the rest were 20 (14.8%) fall from the height. According to radiological outcomes, Mean shaft condylar Angle in group A was 41.5±6.3, in group B was 41.8±1.9 and in group C was 40.1±3.8 respectively (P>0.05). Mean Bauman angle in group A was 18.8±6.11, group B was 19.4±7.5 and in group C 20.4±5.3 with (P>0.05). According to Flynn’s criteria, excellent outcomes were observed in 33 (73.3%) in LA group, 24 (53.3%) in MA group and 22 (48.9%) in PA group, good results were observed in 11(24.4%), 19 (42.2%) and 21 (46.7%), fair outcomes in 1 (2.2%), 2 (4.4%) and 2 (4.4%). Conclusion: As a result of this research, we have concluded that the lateral technique for supracondylar fractures is superior to the medial or posterior approaches in terms of radiological and functional results. However, there was no statistically significant difference between the three groups. Keywords: Supracondylar fractures, Flynn’s criteria, Functional outcome, Open reduction

Type III open tibial fractures in children

2001 ◽  
Vol 11 (3) ◽  
pp. 169-175 ◽  
Author(s):  
M. Fujita ◽  
K. Yokoyama ◽  
T. Tsukamoto ◽  
S. Aoki ◽  
T. Noumi ◽  
...  
Keyword(s):  
Tibial Fractures ◽  
Open Tibial Fractures ◽  
Type Iii ◽  
Fractures In Children
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