391 Multiple Unilateral Upper Limb Fractures in The Paediatric Setting – A Case Report

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
W W Ang ◽  
A Overton ◽  
M Ahmad
Keyword(s):  
Upper Limb ◽  
Full Range ◽  
Careful Examination ◽  
Lateral Condyle ◽  
Forearm Fractures ◽  
Ulna Fracture ◽  
Fractures In Children ◽  
Open Injury ◽  
Left Limb ◽  
Condyle Fracture

Abstract Introduction 5% of forearm fractures in children have associated supracondylar fractures, hence any forearm fractures warrant careful examination of the elbow, and radiographs taken should visualise the elbow and wrist joint for other injuries. We report a case of multiple upper limb fracture in a child, comprising of lateral condyle and both-bone forearm fracture. Case Presentation: A 5-year-old boy was admitted having fallen from a ladder approximately 1.5 metres high in a playground. The left limb was significantly deformed, with no open injury, and neurovascularly intact throughout. Radiographs demonstrated a minimally displaced lateral condyle fracture of the left elbow, a mid-shaft ulna fracture and a displaced off-ended distal third radius and ulna fracture of the left wrist. Any metabolic bone disease and non-accidental injury was ruled out. CT imaging was performed to completely assess the fracture pattern and discussion with our local regional trauma centre. Given the minimal displacement of the lateral epicondyle, conservative management was decided for this. The displaced distal radial fracture was managed with open reduction and internal fixation with a plate, and the ulna shaft fracture with manipulation and plaster cast application. By 12 weeks after surgery there was full range of movement of the elbow, wrist, and forearm, with complete radiological union.

scholarly journals Complications of Lateral Humeral Condyle Fractures in Children

2021 ◽  
Vol 7 (2) ◽  
Keyword(s):  
Treatment Options ◽  
Delayed Union ◽  
Lateral Condyle ◽  
Fractures In Children ◽  
Lateral Condyle Fracture ◽  
Fishtail Deformity ◽  
Spur Formation ◽  
Condyle Fracture ◽  
Internal Oblique ◽  
Humeral Condyle

Lateral humeral condyle fractures in children are easily missed and often associated with complications. These complications include malunion, delayed union or nonunion, lateral spur formation, fishtail deformity and growth disturbances. There is also controversy related to best treatment options including closed vs open reduction and K-wire vs screw fixation. Though some complications like malunion are avoidable, others like lateral spur formation are inevitable. Knowledge about these complications would help in counseling patients and their families. The purpose of this article was to review common complications related to these fractures and suggest tips to avoid some of them. Keywords: Paediatric, Lateral condyle fracture, Internal oblique X-ray, Arthrogram, Anatomical reduction, Complications, Tips to overcome

scholarly journals Results of a Conservative Management of Minimally Displaced Lateral Condyle of Humerus Fracture in Children

2015 ◽  
Vol 12 (1) ◽  
pp. 10-13
Author(s):  
DK Shrestha ◽  
P Bastola ◽  
B Dhungel ◽  
VP Lakhanpal
Keyword(s):  
Range Of Motion ◽  
Operative Treatment ◽  
Full Range ◽  
Humerus Fracture ◽  
Lateral Side ◽  
Lateral Condyle ◽  
Elbow Injury ◽  
Medical College ◽  
Carrying Angle ◽  
Condyle Fracture

Background: Fracture of lateral condyle humerus in pediatric population is second most common elbow injury. There is controversy regarding treatment of minimally displaced (less than 2mm) fracture. If this group can be taken care with non operative treatment it will be an easier and lot cheaper option especially for rural parts of west Nepal.Aim: To see the viability of treatment of minimally displaced lateral condyle humerus fracture with non operative treatment and look for short and immediate results.Methodology: This was a prospective observational, hospital based study carried out in Nepalgunj Medical College teaching Hospital from Jan. 2013 - Jan. 2014. In children between 2.5 - 13 years, with minimally displaced fracture of lateral condyle humerus were radiologically followed up for 12 weeks. All patients underwent long arm cast and serial radiographs in follow ups. At 12 weeks; range of motion, tenderness and carrying angle were looked for.Results: There were 12 patients in the study with average age of 6.95 years, range (SD 2.92). There were no displacements in follow ups. At 6 weeks all had full range of motion and at 12 weeks all had full range of motion without tenderness. Three kids had approximately 5 degrees of carrying angle change on other side to varus.Conclusion: Non operative treatment with 4 weeks of long arm cast in supination is a good alternative option for minimally displaced lateral condyle fracture humerus. A good follow up of the treated patients is an integral part of management along with radiological evidence. Parents need to be warned about bump in the lateral side during healing.Journal of Nepalgunj Medical College Vol.12(1) 2014: 10-13

scholarly journals Comparison of radiological and clinical outcome among Kirschner wires versus 3.5 mm diameter cannulated cancellous screw internal fixation in treatment for the displaced lateral humeral condyle fractures in children

2021 ◽  
Vol 7 (2) ◽  
pp. 219
Author(s):  
Lokpal Singh Bhati ◽  
Ashish Kumar Gupta ◽  
Jitendra Singh Rathor ◽  
Devendra Singh Rathore ◽  
Deepak Kundu
Keyword(s):  
Screw Fixation ◽  
Lateral Condyle ◽  
Cancellous Screw ◽  
Kirschner Wires ◽  
Fractures In Children ◽  
High Incidence ◽  
K Wires ◽  
Condyle Fracture ◽  
Humeral Condyle ◽  
Written Informed Consent

<p><strong>Background:</strong> Lateral humeral condyle fracture, the second most common injury around the elbow, accounts for 10-20% of all fractures of the elbow in children with a high incidence between two and 14 years.</p><p><strong>Methods:</strong> This hospital based prospective randomized comparative study design was include patients of both sexes in age group of 2 to 14 years attending SMS hospital, Jaipur during April 2018 to June 2019 or till the sample size achieved, with due permission from the institutional ethic committee and review board and after taking written informed consent from the patient.</p><p><strong>Results:</strong> 40 patients out of 50 were grouped as excellent (70.1%) while 13 were found good (22.8%) and only four patients were found poor (7.01%) as per Hardacre criteria of assessment of lateral condyle treatment in k wire group while excellent, good and poor results were found 68.4, 24.5 and 7.01% respectively in CC screw groups</p><p><strong>Conclusions:</strong> The displaced fractures (displacement over 2 mm) can be treated successfully by open reduction and K-wires or screw fixation with excellent results.</p><p> </p>

Lateral Condyle Fracture of the Humerus in Children: Kirschner Wire or Screw Fixation?

2020 ◽  
Author(s):  
Danielle S. Wendling-Keim ◽  
Sandra Teschemacher ◽  
Hans-Georg Dietz ◽  
Markus Lehner
Keyword(s):  
Range Of Motion ◽  
Screw Fixation ◽  
Statistical Significance ◽  
Kirschner Wire ◽  
Lower Percentage ◽  
Lateral Condyle ◽  
Fractures In Children ◽  
Kirschner Wire Fixation ◽  
Wire Fixation ◽  
Condyle Fracture

Abstract Introduction The treatment of the displaced fracture of the lateral condyle of the distal humerus in children aims not only to avoid nonunion, malalignment, and impairment of the range of motion of the elbow but also to prevent delayed healing and the development of any prearthrotic deformity. To date there is no agreement on what kind of osteosynthesis should be used. So far, the screw fixation and Kirschner wire fixation have both been applied. Therefore, the goal of this study was to compare the outcome of these two methods. Materials and Methods A retrospective cohort study was undertaken including 43 patients aged 2 to 13 years who underwent osteosynthesis for a condylar fracture of the humerus over a period of 10 years. The electronic archive, including the radiological diagnostics, was analyzed. Statistical analysis was performed using IBM SPSS Statistics 20.0. Statistical significance was set at an α level of p = 0.05. Results Kirschner wire fixation was performed in 48.9% of condylar fractures of the humerus while screw fixation (alone or in combination with a pin) was assessed with a percentage of 51.1% of the cases in this study. Screw fixation only was applied in 20.9% of fractures of the lateral condyle. The selection of the method was independent of the age of the patient (p = 0.2). The comparison of the rate of complications and an impaired range of motion after Kirschner wire osteosynthesis to the rate after screw osteosynthesis showed a significantly lower percentage for the Kirschner wire group (p = 0.046). No case of nonunion, nerve palsy, or pin migration was detected in any patient in this study. Conclusion Kirschner wire fixation of condylar humeral fractures in children resulted in a lower rate of complications than screw fixation. No case of nonunion of the fracture was found in the patients that we investigated so that we conclude that Kirschner wires sufficiently adapt the fracture in these cases. Level of Evidence Level III.

scholarly journals The Association between Bone Mineral Density, Metacarpal Morphometry, and Upper Limb Fractures in Children: A Population-Based Case-Control Study

2003 ◽  
Vol 88 (4) ◽  
pp. 1486-1491 ◽  
Author(s):  
Deqiong Ma ◽  
Graeme Jones
Keyword(s):  
Bone Mineral ◽  
Upper Limb ◽  
Case Control Study ◽  
Population Based ◽  
Forearm Fractures ◽  
Mineral Density ◽  
Fractures In Children ◽  
Limb Fractures ◽  
Upper Limb Fractures ◽  
Control Study

The aim of this population-based case-control study was to examine the association between bone mass and upper limb fractures in children aged 9–16 yr. Areal bone mineral density and bone mineral apparent density (BMAD) were measured by both dual energy absorptiometry (DXA) and metacarpal index (MI) by hand radiograph. A total of 321 fracture cases and 321 randomly selected individually matched controls were studied. For all fractures, cases had lower DXA measures at all sites (1.1–3.3%; all P &lt; 0.05). A larger reduction was observed for those with wrist and forearm fractures (1.2–4.5%; all P &lt; 0.05, except total body BMAD) but not other upper limb fractures (hand, −1.6 to +1.2%; upper arm: 0.9–4.8%; all P &gt; 0.05). For metacarpal measures, cases had a thinner cortical width and lower MI for wrist and forearm fractures only. In multivariate modeling, both spine BMAD (odds ratio, 1.4/sd reduction) and MI (odds ratio, 1.5/sd reduction) remained statistically significant predictors of wrist and forearm fractures. In conclusion, both DXA measures and MI are independently associated with wrist and forearm but not other upper limb fractures. The magnitude of this association is somewhat weaker than in adults but suggests that optimizing age-appropriate bone mass will lessen the risk of fracture in children.

The Result After Surgical Treatment on Lateral Condyle Fracture of Humenu in Children

1999 ◽  
Vol 12 (4) ◽  
pp. 1034
Author(s):  
Dong Soo Kim ◽  
Kook Jin Chung ◽  
Jong Guk Ahn ◽  
Byung Hyun Jung ◽  
Yeol Bo Sung ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Lateral Condyle ◽  
Lateral Condyle Fracture ◽  
Condyle Fracture

scholarly journals Functional outcome of diaphyseal fractures of forearm in adolescents treated with TENS

2019 ◽  
Vol 5 (3) ◽  
pp. 69
Author(s):  
Divyanshu Goyal ◽  
S. L. Sharma ◽  
Laxmikant Meena ◽  
Ravindra Lamoria ◽  
Mahesh Bansal
Keyword(s):  
Range Of Motion ◽  
Functional Outcome ◽  
Case Series ◽  
Age Group ◽  
Forearm Fractures ◽  
Retrospective Case ◽  
Superficial Infection ◽  
Fractures In Children ◽  
Case Series Study ◽  
Diaphyseal Fractures

<p class="abstract"><strong>Background:</strong> A retrospective case series study was done on forearm diaphyseal fracture in adolescents treated with TENS (titanium elastic nailing system). Purpose of the study was analysis of functional outcome of TENS in forearm diaphyseal fractures in children between 12-18 year age group.</p><p class="abstract"><strong>Methods:</strong> We retrospectively evaluated 30 patients operated by same senior surgeon during the period from March 2014 to February 2015 with closed diaphyseal forearm fractures in age group 12–18 years treated with TENS in whom closed reduction could not be achieved. Nail diameter taken as 33-40% of narrowest diameter of diaphysys were introduced proximally in ulna and distally in radius under image intensifier in closed manner. Postoperatively, patients encouraged for active shoulder, elbow and finger movements and suture removal done after 2 weeks. Patients were followed up for minimum period of one year.  </p><p class="abstract"><strong>Results:</strong> In terms of union and range of motion using Anderson et al criteria 24 patients had excellent results, 4 patients had satisfactory results and one patient had poor result having non-union of ulna. Two patients had superficial infection at the nail entry site which eventually resolved. One patient lost for follow up.</p><p class="abstract"><strong>Conclusions:</strong> We conclude that TENS in both bone forearm fractures in adolescent age group in terms of union and range of motion is a minimally invasive and effective method of fixation.</p>

Sign in / Sign up

Export Citation Format

Share Document