scholarly journals Posterolaterally displaced and flexion-type supracondylar fractures are associated with a higher risk of open reduction

2016 ◽  
Vol 25 (5) ◽  
pp. 406-411 ◽  
Author(s):  
Eduardo N. Novais ◽  
Patrick M. Carry ◽  
Bryan J. Mark ◽  
Sayan De ◽  
Nancy H. Miller
2016 ◽  
Vol 4 (1) ◽  
pp. 28
Author(s):  
Rajeev Dwivedi ◽  
Ruban Raj Joshi ◽  
Subin Byanjankar ◽  
Rahul Shrestha

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.


2005 ◽  
Vol 18 (2) ◽  
pp. 185 ◽  
Author(s):  
Chang Ryung Hur ◽  
Seung Woo Suh ◽  
Chang Ug Oh ◽  
In Jung Chae ◽  
Jun Gyu Moon ◽  
...  

2006 ◽  
Vol 88-B (4) ◽  
pp. 528-530 ◽  
Author(s):  
P. J. Walmsley ◽  
M. B. Kelly ◽  
J. E. Robb ◽  
I. H. Annan ◽  
D. E. Porter

2021 ◽  
Vol 53 (3) ◽  
pp. 143-147
Author(s):  
Yoyos Dias Ismiarto ◽  
◽  
Mahyudin ◽  
Adriel Benedict Haryono

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.


2021 ◽  
Vol 9 (6) ◽  
Author(s):  
Gheorghe Burnei ◽  
Ionuţ Răducan ◽  
Florin-Daniel Enache ◽  
Adriana Dărăban ◽  
Cecilia Avram ◽  
...  

Background Context. The presence of special, rare and various forms which we can encounter when treating supracondylar humeral fractures (SHF) in children, call into question what therapeutic methods can be used to increase the effectiveness of the treatment applied. The aim of this paper is to present the results obtained by using double cross-fixation, "in double X", by closed reduction and percutaneous pinning (CRPP) or open reduction and internal fixation (ORIF) in treating rare and particular forms. Comments and opinions on "double X" method and other cross or side configurations are presented. Patient Sample. All patients with rare and particular forms presented in this article, were operated during 2001-2020 in state and private hospitals. Fixation in "double X" was used either by CRPP and ORIF. The epitrochlear approach (EA) was performed in cases where stability by CRPP could not be ensured or when there were clear signs of ulnar nerve damage. The minimal medial-approach (mMA) highlights the epitrochlea and the fracture of the medial pylon; it has the role of anatomically reducing the medial pylon, thinner and very unstable in rare and particular forms. During 1982-2020 we consulted, treated and evaluated patients with SHF to whom all known treatment methods were applied: orthopedic reduction and immobilization in plaster cast, CRPP, ORIF, minimal-open reduction and internal fixation (mORIF) by mMA and external fixator. Internal fixation was done by the techniques of Judet, San Antonio, San Diego, Dorgan, in “X” and “double X”. In 2001, I introduced "double X" fixation to better stabilize anatomical reductions that showed signs of instability during intraoperative verification. All indications given in the study protocol have been made in accordance with the regulations mentioned in the experimental program. Results. All SHFs operated by CRPP and ORIF by “double X” were cured and satisfactory and good results were obtained in the neglected types operated between 14 and 60 days and good and excellent results were obtained in the rare forms. Conclusions. “Double X” fixation gives the best stabilization and postoperatively there is no need for immobilization in a plaster cast. Recovery may begin the day after surgery. Keywords: supracondylar fractures, child elbow pathology, cross-fixation, lateral fixation, healing and recovery after 30-45 days.


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