scholarly journals Open Reduction and Internal Fixation of Displaced Supracondylar Fracture of Late Presentation in Children: A Preliminary Report

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Ram K. Shah ◽  
Raju Rijal ◽  
Rosan P. Shah Kalawar ◽  
Sujit R. Shrestha ◽  
Niraj Kumar Shah
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Late Presentation ◽  
Supracondylar Fracture ◽  
Control Group ◽  
Joint Motion ◽  
Supracondylar Fractures ◽  
Kirschner Wires ◽  
Multicentric Study ◽  
Fractures In Children

Background. In late presentation of cases there is dilemma whether to wait for osteotomy later or do open reduction on arrival. The purpose of this prospective multicentric study is to evaluate the functional outcome of open reduction and internal fixation (ORIF) with crossed Kirschner wires fixation and early joint motion in the late presentation of supracondylar fractures in children. Methods. A total of 21 children, with an average delay of 20.3 days, with displaced type III Gartland supracondylar fracture, were treated by ORIF with crossed Kirschner wires fixation and early joint motion. Average follow-up was 12 months. Results. Flynn’s criteria were used to evaluate the outcome. All of them had more functional range of motion of the injured elbow than the published reports. Conclusions. Most of the surgeons in the developing world prefer ORIF for optimal results. Thus it appears to be justifiable to go for ORIF with K-wires even in the late presentation of supracondylar fractures. The overall results are encouraging. However, the small number of cases and lack of control group are the limitations of this study. The study is ongoing and so the full report with more cases will be presented later.

scholarly journals Management of Displaced Supracondylar Fracture of Late Presentation in Children by Open Reduction and Internal Fixation

KYAMC Journal ◽  
2017 ◽  
Vol 7 (2) ◽  
pp. 745-749
Author(s):  
Md Ashraful Islam ◽  
Md Abdur Rashid ◽  
Md Hafizur Rahman Milon ◽  
Mohammed Solayman ◽  
Md Asmaul Hossain Khan
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Late Presentation ◽  
Supracondylar Fracture ◽  
Control Group ◽  
Joint Motion ◽  
Supracondylar Fractures ◽  
Kirschner Wires ◽  
Average Delay ◽  
Multicentric Study

Background: In late presentation of cases there is dilemma whether to wait for osteotomy later or do open reduction on arrival. The purpose of this prospective multicentric study is to evaluate the functional outcome of open reduction and internal fixation (ORIF) with crossed Kirschner wires fixation and early joint motion in the late presentation of supracondylar fractures in children.Methods: A total of 21 children, with an average delay of 22.5 days, with displaced type III Gartland supracondylar fracture, were treated by ORIF with crossed Kirschner wires fixation and early joint motion. Average follow-up was 12 months.Results: Flynn's criteria were used to evaluate the outcome. All of them had more functional range of motion of the injured elbow than the published reports.Conclusions: Most of the surgeons in the developing world prefer ORIF for optimal results. Thus it appears to be justifiable to go for ORIF with K-wires even in the late presentation of supracondylar fractures. The overall results are encouraging. However, the small number of cases and lack of control group are the limitations of this study. The study is ongoing and so the full report with more cases will be presented later.KYAMC Journal Vol. 7, No.-2, Jan 2017, Page 745-749

scholarly journals Functional and radiological outcome after closed reduction and percutaneous pinning versus open reduction and internal fixation in displaced supracondylar fractures in children

2016 ◽  
Vol 19 (2) ◽  
pp. 21-27 ◽  
Author(s):  
Amin Kumar Shrestha ◽  
Suresh Uprety ◽  
Govinda K.C. ◽  
Sharma Paudel
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Supracondylar Fracture ◽  
Age Group ◽  
Radiological Outcome ◽  
Percutaneous Pinning ◽  
Supracondylar Fractures ◽  
Fractures In Children ◽  
Significant Difference ◽  
The Mean

Introduction: Supracondylar fracture of humerus is very common fracture in pediatric age group. The current trends of management in displaced type are close reduction and per cutaneous pinning (CRPP), if reduction is not satisfactory then open reduction and internal fixation (ORIF) is done.  Our study aims to compare the cosmetic, functional and radiological outcome between these two methods. Methodology: Children with displaced extension type supracondylar fracture of distal humerus presenting to emergency room and orthopedics OPD who could meet the inclusion criteria were taken up for study. Sixty-three such patients (37 CRPP and 26 ORIF) were included in the study. Radiological and functional outcomes were followed up at 8 weeks post-operatively. Results: Of the 63 patients enrolled, 26 (41.3%) patients had undergone open reduction and internal fixation and 37 (58/7%) had undergone close reduction and percutaneous pinning. The mean age of patients in CRPP and ORIF groups was 7.29±2.3 years and 8.11±2.02 years respectively. Maximum patients were from age group 7-9 years (46%). Left side was more commonly injured (66.7% vs. 33.3%) (P = 0.045). According to the Flynn’s criteria, cosmetically the outcome did not differ between the two surgical groups (P = 0.23). However, CRPP proved to have a significantly better functional outcome (P=0.000). The mean Bauman’s angle in CRPP and ORIF groups was 16.89±5.66 and 18.88±4.90 degrees respectively. However, there is no statistically significant difference between the type of fixation and Bauman’s angle or Anterior humeral line. Conclusions: Close reduction and percutaneous pinning (CRPP) has better functional and radiological outcome in comparison with open reduction and internal fixation (ORIF) in displaced supracondylar fracture of humerus in children.

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

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.

scholarly journals Percutaneous leverage reduction with two Kirschner wires combined with the Métaizeau technique versus open reduction plus internal fixation with a single Kirschner-wire for treating Judet IV radial neck fractures in children

2019 ◽  
Vol 47 (11) ◽  
pp. 5497-5507 ◽  
Author(s):  
Xiangping Du ◽  
Lirong Yu ◽  
Zhigang Xiong ◽  
Gan Chen ◽  
Jun Zou ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
The Novel ◽  
Kirschner Wires ◽  
Radial Neck ◽  
Novel Treatment ◽  
Fractures In Children ◽  
Radial Neck Fractures ◽  
Elbow Function ◽  
K Wires

Objective To compare the clinical effectiveness of a novel approach, percutaneous leverage reduction using two Kirschner-wires (k-wires) combined with the Métaizeau technique, versus open reduction plus internal fixation with k-wire for the treatment of Judet IV radial neck fractures in children. Methods Thirty-four patients with Judet IV radial neck fractures were treated either with percutaneous leverage reduction using two k-wires and the Métaizeau technique (n = 16) or open reduction plus internal fixation with k-wire (n = 18). Patient data including sex, age, time from trauma to surgery, fracture type, follow up, postoperative healing time, X-ray studies, elbow function, and complications were collected. Results There were no significant differences in patient characteristics between the two treatment groups. In postoperative elbow function assessment, 93.8% of patients in the group that underwent the novel treatment approach had a score of excellent or good, compared with 83.3% of patients in the open reduction and internal fixation with k-wire group. Furthermore, no postoperative complications were reported in patients in the novel treatment group, compared with 5 patients in the open reduction and internal fixation with k-wire group. All patients in both groups were classified as excellent or good according to Métaizeau criteria in postoperative X-ray assessment. Conclusions Compared with the open reduction and internal fixation with k-wire approach, percutaneous leverage reduction using two k-wires combined with the Métaizeau technique can significantly increase the minimally invasive reduction rate, and represents an attractive strategy for the treatment of Judet IV radial neck fractures in children.

scholarly journals OPEN REDUCTION AND K-WIRE FIXATION OF DISPLACED UNSTABLE LATERAL CONDYLE FRACTURES OF THE HUMERUS IN CHILDREN

2011 ◽  
Vol 18 (03) ◽  
pp. 501-509
Author(s):  
NOOR AKBAR SIAL ◽  
MUHAMMAD JAVAID IQBAL ◽  
MUHAMMAD KALEEM SHAUKAT
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Late Presentation ◽  
Lateral Condyle ◽  
Post Injury ◽  
Medical College ◽  
Fractures In Children ◽  
Pin Fixation ◽  
Wire Fixation ◽  
K Wires

Background: Lateral condyle fractures in children are the second most common fracture about the elbow. The problem arises in those cases which are difficult to treat by pop cast or by close reduction with percutaneous pin fixation. Late presentation is another challenge. We selected surgical treatment for such cases up to 12 weeks to evaluate our results. Objective: To study the usefulness of open reduction and K-wire fixation of displaced, unstable with or without rotation of fractures lateral condyle of the humerus in children presenting up to 12 weeks post injury Design: Prospective. Setting: Three teaching orthopaedic units Independent Medical College / Punjab Medical College, and University Medical College Faisalabad. Period: From January 2008 to December 2010. Method: In this prospective study a series of 22 patients were treated using technique of open reduction and internal fixation with k-wires. The results were assessed by criteria of Agarwal et al with little modification after follow-up for 1 year. Results: Excellent to good results were observed in all the12 patients presenting at 1–4 weeks post injury. In 5 patients presenting at 5–8 weeks, the results were excellent in one, good in 2, fair in1 and poor in one patient. In 5 patients presenting at 9-12 weeks good in 1 fair in 2 and poor in 2 patients. Conclusions: Open reduction and internal fixation is an effective treatment in all cases of displaced fractures of the lateral condyle of the humerus presenting up to 12 weeks post injury on the basis of low surgical complications and high union rate.

scholarly journals Supracondylar fracture, buried vs non buried K wires.

2020 ◽  
Vol 27 (03) ◽  
pp. 467-471
Author(s):  
Usama Bin Saeed ◽  
Muhammad Waseem ◽  
Allah Rakha Hassan ◽  
Zeeshan Ali Khan ◽  
Dilshad Gill ◽  
...  
Keyword(s):  
Tract Infection ◽  
Internal Fixation ◽  
Open Reduction ◽  
Supracondylar Fracture ◽  
Supracondylar Fractures ◽  
Elbow Fractures ◽  
Group A ◽  
K Wires ◽  
Pin Tract Infection ◽  
Group B

Supracondylar fracture of the humerus is the second most common fracture in children (16.6%), and is most common fracture around the elbow in children comprise (60%) to (75%) of all elbow fractures. There is very little data available about the burier of wires under the skin reduces the pin tract infection rate as low as 2.27%.2 Objectives: To compare the frequency of pin tract infection between nonburied and buried K-wires after open reduction internal fixation in supracondylar fracture of humerus in children. Study Design: Prospective Cohort Study. Setting: Department of Orthopedics Surgery & Traumatology Allied Hospital Faisalabad. Period: From June 2014 - June 2017. Material & Methods: Patients were selected according to the inclusion criteria. All patients were registered in ER with a history of trauma and having the diagnosis of Supracondylar fracture. Two groups were made; Group A (Buried), Group B (Non-buried). They were followed for the signs of infection. Results:  Out of 80 cases 45 (56.3 %) were male and 35 (43.8 %) female. In group A (non-buried) there were 40 patients and Mean age was 7.57± 2.07 years, pin tract were infected in 8 (20%) patients and there were no pin tract infection in 32 (80%) patients. And in group B (buried) there were 40 patients and mean age was 7.38± 2.17 years, Pin tract was infected in 1(2.5%) patient and there were no pin tract infection in 39(97.5%). Conclusion: Our study showed that rate of infection is significantly reduced in burying of K-wires after open reduction and internal fixation of supracondylar fractures as compared to non-burying technique.

Open Reduction and Internal Fixation of Intra-articular Calcaneal Fractures in Children

Orthopedics ◽  
2012 ◽  
Vol 35 (6) ◽  
pp. e874-e879 ◽  
Author(s):  
Guang-rong Yu ◽  
Hong-mou Zhao ◽  
Yun-feng Yang ◽  
Jia-qian Zhou ◽  
Hai-feng Li
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Calcaneal Fractures ◽  
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.

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