Supracondylar fractures of the humerus in childhood: range of movement following the posterior approach to open reduction

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

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Treatment of Phalangeal Fractures by Tension Band Wiring

Journal of Hand Surgery (European Volume) ◽

10.1054/jhsb.2000.0499 ◽

2001 ◽

Vol 26 (1) ◽

pp. 50-52 ◽

Cited By ~ 22

Author(s):

Y. SAFOURY

Keyword(s):

Retrospective Study ◽

Open Reduction ◽

Tension Band ◽

Tension Band Wiring ◽

Range Of Movement ◽

Intraarticular Fractures ◽

Phalangeal Fractures

This retrospective study assessed the outcomes of 30 patients with phalangeal fractures which were treated by open reduction and tension band wiring. Oblique, transverse and comminuted extraarticular fractures, as well as intraarticular fractures, were treated with this technique and they all united in about 8 weeks. There were no significant complications. At a mean follow-up period of 2.3 years, the active range of movement of the involved fingers was excellent in 17, and good in 13 instances. There were no fair or poor results.

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Modified supracondylar dome osteotomy: our experience in 11 children

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20172504 ◽

2017 ◽

Vol 3 (4) ◽

pp. 766

Author(s):

Abhinav . ◽

Ajoy Kumar Manav ◽

Arjun Singh

Keyword(s):

Posterior Approach ◽

Plate Fixation ◽

Excellent Result ◽

Older Children ◽

Supracondylar Fractures ◽

Loss Of Correction ◽

Dome Osteotomy ◽

K Wires ◽

The Stability ◽

Supracondylar Dome Osteotomy

Background: The present retrospective study was done with 11 children having cubitus varus following supracondylar fractures to access the stability of modified domeosteotomy and its fixation with k-wires in older children.Methods: 11 children, 7 males & 4 females were included in the study. The osteotomy was performed through posterior approach. The triangular wedge rotated inside the notch was inherently stable and also fixed with k-wires. Patients were followed at regular intervals. K wires were removed at 6 weeks and the physiotherapy started.Results: The correction obtained under vision was well maintained post operatively in 10 out of 11 cases. In only one case there was back out of k-wires and loss of correction. 5 cases had excellent result followed by 4 good and one fair result. Conclusions: Modified dome osteotomy performed through posterior approach and fixed with k-wires gives good results. Removal of the k-wires is simple. However, in children above 14 years plate fixation might be better to prevent loss of correction.

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Surgical Outcomes of Pediatric Humeral Supracondylar Fractures Treated By Posterior Approach and Triceps Splitting

Journal of Trauma & Treatment ◽

10.4172/2167-1222.s4-007 ◽

2013 ◽

Vol s4 ◽

Author(s):

Omidi Kashani F

Keyword(s):

Surgical Outcomes ◽

Posterior Approach ◽

Supracondylar Fractures

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Outcomes of Pediatric Supracondylar Fractures of Humerus Treated by Posterior Triceps Splitting Approach

Journal of Lumbini Medical College ◽

10.22502/jlmc.v4i1.83 ◽

2016 ◽

Vol 4 (1) ◽

pp. 28

Author(s):

Rajeev Dwivedi ◽

Ruban Raj Joshi ◽

Subin Byanjankar ◽

Rahul Shrestha

Keyword(s):

Internal Fixation ◽

Open Reduction ◽

Standard Treatment ◽

Functional Results ◽

Supracondylar Fracture ◽

Supracondylar Fractures ◽

Radiological Criteria ◽

Supracondylar Humeral Fractures ◽

The Mean ◽

Mean Time

Introduction: Close reductions and percutaneous pinning is the gold standard treatment for supracondylar fracture of humerus. Open reduction and internal fixation is indicated in patients with unacceptable closed reduction, neurovascular compromise, and open fractures. Open reduction can be performed through various approaches. Every approach has their advantages and limitations. The aim of this study was to assess the functional outcome of pediatric supracondylar fracture of humerus treated by posterior triceps splitting approach. Methods: This was a prospective evaluation of 20 consecutive patients with displaced pediatric supracondylar humeral fractures operated by triceps spitting posterior approach in our institution for two years. At initial presentation, 19 cases were Gartland III and one was flexion variant of injury. Complications such as reduction loss, pin migration, infection, osteonecrosis of any part of the elbow, bone healing, and functional results were evaluated. Flynn criteria were used to evaluate the final results. Results: Twenty patients underwent open reduction and internal fixation by triceps splitting approach. Thirteen patients were male and seven were female with M:F ratio of 1.86:1. The mean age was 6.8 yr (SD=2.74, range 2-14). All the fractures united by six weeks; mean time for union was 4.5 wk (SD=0.94). All patients were assessed at six months using Flynn clinical and radiological criteria. Results were satisfactory in all patients. Conclusion: Posterior triceps splitting approach is simple, safe and has good functional and radiological outcome. We recommend this approach for open reduction and internal fixation in pediatric supracondylar fracture.

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