scholarly journals A Study of Vascular Injuries in Pediatric Supracondylar Humeral Fractures

2001 ◽  
Vol 9 (2) ◽  
pp. 37-40 ◽  
Author(s):  
Ritabh Kumar ◽  
Vivek Trikha ◽  
Rajesh Malhotra
Keyword(s):  
Vascular Injury ◽  
Surgical Approach ◽  
Open Reduction Internal Fixation ◽  
Vascular Injuries ◽  
Supracondylar Fractures ◽  
Satisfactory Outcome ◽  
Vascular Compromise ◽  
Supracondylar Humeral Fractures ◽  
Aggressive Surgical Approach ◽  
Grade Iii

194 children with supracondylar fractures of the humerus were reviewed. Of the 49 children with Gartland grade III displacement, signs of vascular compromise were clinically suspected in 5 cases. Immediate open reduction, internal fixation and exploration were performed. Four children had a satisfactory outcome. One child required amputation. A careful clinical evaluation for vascular injury and an aggressive surgical approach is suggested, when indicated.

scholarly journals Neurovascular injury in supracondylar fracture of Humerus

2013 ◽  
Vol 34 (3) ◽  
pp. 12-16
Author(s):  
KR Shrestha ◽  
R Sapkota ◽  
N Rajbhandari ◽  
B Thapa ◽  
UK Shrestha
Keyword(s):  
Vascular Injury ◽  
Outpatient Setting ◽  
Supracondylar Fracture ◽  
Institute Of Medicine ◽  
Supracondylar Fractures ◽  
Posterior Displacement ◽  
Neurovascular Injury ◽  
Fractures In Children ◽  
Satisfactory Outcome ◽  
Elbow Fractures

Introduction: Supracondylar fractures of the humerus are the commonest upper limb fractures in children, accounting for up to 70% of all pediatric elbow fractures. Supracondylar fractures of the humerus can be managed in outpatient setting but are often complicated by neurovascular injury. Methods: Retrospective study including 187 patients who had presented with supracondylar fracture of humerus with 47 neurovascular injuries during the period of July 2007 to June 2011. Out of 142 patients with Gartland type III fracture 107 underwent immediate open reduction, exploration and internal fixation. Results: Vascular injury is commonly associated with type II supracondylar fracture with posterior displacement. Twenty two patients had vascular injury and all of them had satisfactory outcome after surgery. Conclusion: A careful clinical evaluation, urgent surgical treatment and adequate fracture reduction can prevent lifelong handicap. DOI: http://dx.doi.org/10.3126/joim.v34i3.8909 Journal of Institute of Medicine, December, 2012; 34:12-16

scholarly journals Surgical Repair of Lower Extremity Vascular Injuries in Children: Two Cases

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Mehmet Tasar ◽  
Nur Dikmen Yaman ◽  
Cahit Saricaoglu ◽  
Zeynep Eyileten ◽  
Bulent Kaya ◽  
...  
Keyword(s):  
Case Report ◽  
Lower Extremity ◽  
Vascular Injury ◽  
Congenital Heart Defects ◽  
Surgical Approach ◽  
Congenital Heart ◽  
Surgical Repair ◽  
Heart Defects ◽  
Vascular Injuries ◽  
Transcatheter Intervention

The use of percutaneous devices is commonplace for the treatment of many congenital heart defects. However, there are some situations where procedure-related complications are encountered and surgical help is required to ameliorate this issue. Vascular injury due to transcatheter intervention is a significant and challenging complication and occasionally requires surgical approach. In this case report, we aimed to present successful surgical management of vascular injuries associated with percutaneous interventions in children.

scholarly journals Oligometastatic Growing Teratoma Syndrome: A Case for an Aggressive Surgical Approach

2015 ◽  
Vol 9 (3) ◽  
pp. 163-165 ◽  
Author(s):  
William S. Gange ◽  
Robert H. Blackwell ◽  
John Biemer ◽  
Güliz A. Barkan ◽  
Maria M. Picken ◽  
...  
Keyword(s):  
Surgical Approach ◽  
Clinical Stage ◽  
Mature Teratoma ◽  
Disease Free Survival ◽  
Testicular Germ Cell Tumor ◽  
Testicular Germ Cell ◽  
Growing Teratoma Syndrome ◽  
Aggressive Surgical Approach ◽  
Metastatic Sites

Growing teratoma syndrome is an infrequent presentation of testicular cancer. We present a case of growing teratoma syndrome in a patient who initially presented with clinical stage I nonseminomatous testicular germ cell tumor, who subsequently developed large volume oligometastases to the retroperitoneum, thorax, and thigh. Despite two regimens of chemotherapy, his disease progressed. Complete surgical extirpation of all gross tumors confirmed mature teratoma. An aggressive surgical approach, including postchemotherapy resection of all known metastatic sites, can provide long-term disease-free survival.

scholarly journals Vascular injuries during gynecological laparoscopy: the vascular surgeon's advice

2005 ◽  
Vol 123 (1) ◽  
pp. 38-41 ◽  
Author(s):  
Marcello Barbosa Barros ◽  
Francisco S. Lozano ◽  
Luis Queral
Keyword(s):  
Small Bowel ◽  
Vascular Surgery ◽  
Vascular Injury ◽  
Postoperative Period ◽  
Vascular Injuries ◽  
Venous Graft ◽  
Vascular Surgeon ◽  
Gynecological Laparoscopy

CONTEXT: Iatrogenic vascular problems due to laparoscopy are a well recognized problem and lead to significant repercussions. In this context, a ten-year review of cases topic is presented, based on experience gained while heading two important vascular surgery services. CASES: Five patients with vascular injuries during elective laparoscopy are described. These patients presented with seven lesions of iliac vessels. All cases were evaluated immediately and required laparotomy, provisional hemostasis and urgent attendance by a vascular surgeon. Direct suturing was performed in three cases. One aortoiliac bypass and one ilioiliac reversed venous graft were made. Venous lesions were sutured. One case of a point-like perforation of the small bowel was found. There were no deaths and no complications during the postoperative period. DISCUSSION: Important points on this subject are made, and advice is given. There needs to be immediate recognition of the vascular injury, and expert repair by a vascular surgeon is recommended, in order to significantly reduce the degree of complications.

scholarly journals Delayed Presentation Of Missed Vascular Injuries And Pitfalls In Primary Treatment– Experience Of A Vascular Surgery Unit In Pakistan

2018 ◽  
Vol 08 (04) ◽  
pp. 258-262
Author(s):  
Ahsin Manzoor Bhatti ◽  
Junaid Mansoor ◽  
Haroon Sabir Khan
Keyword(s):  
Vascular Surgery ◽  
Vascular Injury ◽  
Tertiary Care ◽  
Primary Treatment ◽  
Vascular Trauma ◽  
Adverse Outcomes ◽  
Delayed Presentation ◽  
Vascular Injuries ◽  
Vascular Repair ◽  
Missed Injuries

Objective: To analyze errors in primary treatment of vascular injuries and delayed presentations of missed vascular injuries as a surrogate indicator of need for improved vascular surgical training of upcoming general surgeons. Materials and methods: This retrospective observational study was carried out at vascular surgery department of two tertiary care hospitals of Armed Forces from Jan 2012 to June 2017. Hospital records of all patients with vascular trauma were analyzed for presence of pitfalls in primary treatment and delayed presentation of missed vascular injuries which resulted in redo surgeries or adverse outcomes. Results: Out of 256 patients with vascular injury sequel 41 had either a problem in primary treatment or presented with delayed complications of missed injuries. The omissions can be divided into: missed injuries (24/41), technical errors in initial repair (12/24), reperfusion of mangled Extremity (3/41) and non availability of a surgeon capable of undertaking vascular repair. The commonest operative fault was failure to debride the vessel adequately and vascular repair under tension. The commonest primary assessment problem was failure to timely appreciate hard signs of vascular injury. Conclusion: With better training and emphasizing the need of thorough clinical examination outcome of vascular trauma can be improved.

scholarly journals Functional outcome of crossed Kirschner wire fixation in pediatric supracondylar humerus fracture

2019 ◽  
Vol 5 (5) ◽  
pp. 772
Author(s):  
Rahat Zahoor Moton ◽  
Adeel Ahmed Siddiqui ◽  
Muhammad Naseem ◽  
Uzair Yaqoob ◽  
Syed Amir Jalil ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Kirschner Wire ◽  
Humeral Fractures ◽  
Treatment Modalities ◽  
Class Iii ◽  
Supracondylar Fractures ◽  
Fractures In Children ◽  
Kirschner Wire Fixation ◽  
Wire Fixation ◽  
Supracondylar Humeral Fractures

<p class="abstract"><strong>Background:</strong> Distal humeral fractures are one of the most common types of fractures in children, most of them being supracondylar. Supracondylar fractures are usually caused by trauma, most likely falls. It is an emergency, requiring rapid diagnosis and management to avoid serious complications. Recommended treatment modalities vary from no reduction and immobilization to open reduction and internal fixation. Kirschner wire (K-wire) fixation of displaced supracondylar fractures after closed reduction is a preferred method and is being performed for over 50 years now. This study was conducted to determine the functional outcome of crossed K-wire fixation in pediatric supracondylar fracture.</p><p class="abstract"><strong>Methods:</strong> This prospective study was conducted from May-November 2018 at the department of Orthopedics, Abbasi Shaheed Hospital, Karachi, Pakistan. It was inferred that functional outcome of pediatric displaced supracondylar humeral fractures is satisfactory when managed with percutaneous crossed K-wire fixation. It included 83 children with supracondylar fractures. They were treated with percutaneous crossed K-wire fixation. Patients were then followed up to determine satisfactory functional outcome according to Flynn’s criteria. Data entry and analysis was done using SPSS 21.0.</p><p class="abstract"><strong>Results:</strong> Eight-three patients were included. The mean±standard deviation age of this study population was 7.03±3.39 years. Out of the study participants, 47 (56.6%) were males and 36 (43.4%) were females. 71.1% of the patients were of Gartland class II fractures and 28.9% were of Gartland class III. 43.4% had an injury due to fall while playing while 19.3% had fallen from height. 80.7% were found to have a satisfactory functional outcome.</p><p class="abstract"><strong>Conclusions:</strong> It was inferred that the functional outcome of pediatric displaced supracondylar humeral fractures is satisfactory when managed with percutaneous crossed K-wire fixation.</p>

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.

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