scholarly journals Spontaneous humeral torsion deformity correction after displaced supracondylar fractures in children

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Anna K. Hell ◽  
Claudia Gadomski ◽  
Lena Braunschweig
Keyword(s):  
Deformity Correction ◽  
Supracondylar Fractures ◽  
Level Of Evidence ◽  
Average Decrease ◽  
Fractures In Children ◽  
Supracondylar Humerus Fractures ◽  
Significant Correction ◽  
Humeral Torsion ◽  
The Difference ◽  
One Year

Abstract Background After displaced supracondylar humerus fractures (SCHF) in children, residual deformities are common with cubitus varus (CV) being the clinically most visible. Distal fragment malrotation may lead to instability, fragment tilt and subsequent CV. Detection and assessment of malrotation is difficult and the fate of post-traumatic humeral torsion deformity is unknown. The aim of this study was to evaluate the incidence of humeral torsion differences in children with surgically treated SCHF and to observe spontaneous changes over time. Methods A cohort of 27 children with displaced and surgically treated SCHF were followed prospectively from the diagnosis until twelve months after trauma. Clinical, photographic, sonographic and radiological data were obtained regularly. Differences in shoulder and elbow motion, elbow axis, sonographic humeral torsion measurement and radiological evaluation focusing on rotational spur were administered. Results Six weeks after trauma, 67% of SCHF children had a sonographically detected humeral torsion difference of > 5° (average 14.0 ± 7.6°). Of those, 44% showed a rotational spur, slight valgus or varus on radiographs. During follow-up, an average decrease of the difference from 14° (six weeks) to 7.8° (four months) to 6.5° (six months) and to 4.9° (twelve months) was observed. The most significant correction of posttraumatic humeral torsion occurred in children < 5 years and with internal malrotation > 20°. Conclusion After displaced and surgically treated SCHF, most children had humeral torsion differences of both arms. This difference decreased within one year after trauma due to changes on the healthy side or correction in younger children with severe deformity. Level of Evidence/Clinical relevance Therapeutic Level IV

Comparison of Outcome of Three Different Approaches for Supracondylar Humerus Fractures in Children

2021 ◽  
Vol 15 (10) ◽  
pp. 3482-3484
Author(s):  
Syed Usman Shah ◽  
Mohammad Younas ◽  
Naseer Ullah Khattak ◽  
Amina Gul Shehzar Khan ◽  
Sultan Shah ◽  
...  
Keyword(s):  
Posterior Approach ◽  
Lateral Approach ◽  
Supracondylar Fractures ◽  
Medial Approach ◽  
Fractures In Children ◽  
Supracondylar Humerus Fractures ◽  
Significant Difference ◽  
Group A ◽  
Humerus Fractures ◽  
Group B

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

scholarly journals Epidemiology of paediatric elbow fractures: a retrospective multi-centre study of 488 fractures

2019 ◽  
Vol 13 (5) ◽  
pp. 516-521 ◽  
Author(s):  
H. Okubo ◽  
M. Nakasone ◽  
M. Kinjo ◽  
K. Onaka ◽  
C. Futenma ◽  
...  
Keyword(s):  
Case Series ◽  
Fracture Rate ◽  
Lateral Condyle ◽  
Supracondylar Fractures ◽  
Level Of Evidence ◽  
Multi Centre Study ◽  
Fractures In Children ◽  
Elbow Fractures ◽  
Operation Rate ◽  
Age Range

Purpose Elbow fractures are common in children and occur during daily activities. The aim of this study is to evaluate the epidemiology of paediatric elbow fractures over a two-year period in Okinawa, a southern subtropical island in Japan. Methods This was a retrospective study of 488 elbow fractures in children younger than 15 years old treated at 11 hospitals in Okinawa. Data included age, gender, calendar month, type of fracture, operation rate, mechanism of injury, and aetiology. Results The most frequent age was 6 years old, with 47.5% of all elbow fractures occurring in an age range from 6 to 10 years old. The fracture rate for boys was 1.6 times higher than that for girls. The incidence was the highest in May (56 fractures) and the lowest in August (25 fractures). Supracondylar fractures were the most common type (44%), followed by lateral condyle fractures (22%); 45% of all fractures were treated operatively. Medial epicondyle fractures had the highest rate of operative treatment (91%). In the 6 to 10-year-old group, 19% of all fractures occurred while skateboarding or caster-boarding, the most frequent aetiology. Conclusions Supracondylar fractures are the most common fracture type in 4 to 7-year-old boys. In the 6 to 10-year-old group, skateboarding and caster-boarding are the most frequent and increasing cause of elbow fractures. Therefore, some preventive measures are needed. Level of evidence Level IV, case series

scholarly journals Therapeutically effect of the physical procedures on the elbow contractures in children with supracondylar humerus fractures

2007 ◽  
Vol 54 (2) ◽  
pp. 39-43 ◽  
Author(s):  
S.Dj. Jandric
Keyword(s):  
Physical Therapy ◽  
Range Of Motion ◽  
Elbow Joint ◽  
Pediatric Population ◽  
Excellent Result ◽  
Supracondylar Fractures ◽  
Functional Disturbance ◽  
Fractures In Children ◽  
Supracondylar Humerus Fractures ◽  
Humerus Fractures

Supracondylar humerus fractures are the most common fracture around the elbow in the pediatric population. These fractures in children may lead to functional disturbance with loss or reduction of range of motion in the elbow joint. The aim of this study was to investigate the effect of the physical therapy on the range of the motion of the elbow joint in the post-traumatic elbow contractures in the childhood after supracondylar fractures. We analyzed in this research 34 children (average age 8.57+2.94 years) with elbow contractures that were treated by physical therapy after orthopedic treatment. Functional outcome was presented in degree from 1 to 3 (Flynn). The difference in the grade at the beginning and the end of the therapy is statistically significant (t=16.38, p<0.001). 91.18 %, of the children had excellent result. Complex of various therapeutically physical procedures can significant improve range of motion of the elbow joint. .

scholarly journals Does the timing of surgery affect outcomes of gartland type III supracondylar fractures in children?

2019 ◽  
Vol 7 (2) ◽  
pp. 25-32
Author(s):  
Hyun-Chul Shon ◽  
Ji Wan Kim ◽  
Hun-Kyu Shin ◽  
Eugene Kim ◽  
Se-Jin Park ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Clinical Outcomes ◽  
Operation Time ◽  
Timing Of Surgery ◽  
Bone Union ◽  
Supracondylar Fractures ◽  
Type Iii ◽  
Fractures In Children ◽  
Pin Fixation ◽  
Supracondylar Humerus Fractures

Background. Gartland type III supracondylar fractures in children are treated as emergency. But there are few studies about surgical timing and clinical outcomes. Aim. To evaluate whether the time interval from injury to surgical treatment affects the treatment outcomes of Gartland type III supracondylar fractures in children. Methods. The study population comprised all children presenting to our hospital between April 2003 and December 2013, who had Gartland type III supracondylar humerus fracture. Patients were divided into three groups: those who were treated within less than six hours from injury, those who were treated between six and twelve hours, and those who were treated between twelve and twenty four hours after injury. In this retrospective study, we checked whether the timing of surgery affected clinical outcomes such as bone union, range of motion, peri-operative complications, and operation time. Results. All patients were treated with closed reduction and percutaneous pin fixation within 24 hours. This study showed a trend that the delay in the timing of surgery after traumatic injury increases operation time, however with no statistical differences. The neurological complications were similar in the three groups. There were 11 cases (14.7%) of preoperative neurologic deficit, however every patient recovered postoperatively. There was no difference between the three groups in terms of clinical outcomes such as range of motion of the elbow and bone union. Conclusion. For Gartland III pediatric supracondylar humerus fractures, operation can be delayed for up to 24 hours, which may allow time for operation during regular hours, rather than late at night, with thorough evaluation of circulation, nerve injury, and swelling.

scholarly journals Open Reduction of Supracondylar Humerus Fractures in Children for Failed Closed Reduction: Outcome of Delayed Treatment

2021 ◽  
Vol 53 (3) ◽  
pp. 143-147
Author(s):  
Yoyos Dias Ismiarto ◽  
◽  
Mahyudin ◽  
Adriel Benedict Haryono
Keyword(s):  
Closed Reduction ◽  
Open Reduction ◽  
Kirschner Wire ◽  
Early Group ◽  
Supracondylar Fractures ◽  
Delayed Treatment ◽  
Type Iii ◽  
Fractures In Children ◽  
Kirschner Wire Fixation ◽  
Supracondylar Humerus Fractures

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.

scholarly journals Three lateral divergent pinning for displaced supracondylar humerus fractures in children

2015 ◽  
Vol 1 (2) ◽  
pp. 30-34
Author(s):  
Rojan Tamrakar ◽  
Ramod Khanal ◽  
Balakrishnan M. Acharya ◽  
Nabees Man Singh Pradhan ◽  
Suman Kumar Shrestha
Keyword(s):  
Closed Reduction ◽  
Image Intensifier ◽  
Supracondylar Fractures ◽  
Stable Fixation ◽  
Fractures In Children ◽  
Loss Of Reduction ◽  
Supracondylar Humerus Fractures ◽  
Supracondylar Humeral Fractures ◽  
Humerus Fractures ◽  
Ulnar Nerve Injury

Introductions: Cross or two lateral pinnings are the most commonly done procedures for displaced supracondylar humerus fractures in children. A crossed pin is biomechanically stable than lateral pins, but associated with risk of iatrogenic ulnar nerve injury. Recent studies have shown stable fixation with three lateral pin construct. The purpose of this study was to evaluate the efficacy of three lateral divergent pinning for displaced supracondylar humerus fractures.Methods: Thirty five children with Gartland types III were treated between November 2012 and November 2013. Closed reduction and three lateral divergent pinning was done with image intensifier guidance. Patients were followed up for minimum 6 months. Radiological assessment was done to see union, proper pin placement and loss of reduction. Clinically, patients were assessed by using Flynn criteria.Results: There were 24 (68.6%) male and 11 (31.4%) female children between 2 to 13 years of age with displaced supracondylar fractures, left side 26 (74.3%) and right nine (25.7%) cases. All were successfully managed with closed reduction and three lateral divergent pins within 2-6 days of injury. One radial and one median nerve palsies sustained at injury recovered spontaneously. No iatrogenic nerve injuries occurred. A comparison of perioperative and final radiographs revealed no loss of reduction. Twenty-seven excellent, five good, two fair and one poor results on Flynn’s grading. One patient had a superficial pin-tract infection.Conclusions: Closed reduction with three lateral divergent pins is safe for stable fixation of displaced supracondylar humeral fractures in children.

scholarly journals How long does treated supracondylar humerus fracture in children take to recover elbow range?

2019 ◽  
Vol 5 (5) ◽  
pp. 860
Author(s):  
Abhinav D. D. Jogani ◽  
Tushar N. Rathod ◽  
Chetan V. Shende ◽  
Nandan Marathe
Keyword(s):  
Recovery Period ◽  
Control Group ◽  
Distal Forearm ◽  
Forearm Fractures ◽  
Supracondylar Fractures ◽  
Fracture Group ◽  
Fractures In Children ◽  
Management Protocol ◽  
Supracondylar Humerus Fractures ◽  
Distal Forearm Fractures

<p class="abstract"><strong>Background:</strong> Our goal was to address requirement of physiotherapy after treatment of supracondylar humerus fractures in children and evaluate result of casting on elbow without injury using control group of distal forearm fractures.</p><p class="abstract"><strong>Methods:</strong> 57 cases of supracondylar fractures were included in this retrospective study and compared with group of 54 children with distal forearm fractures treated with long arm casting for 28 days. Passive elbow ROM was checked with goniometer on day of cast removal, 2 weeks later, and then every month until the elbow ROM returned to 95% ROM (ROM-95) of uninjured side. No physiotherapy was given.</p><p class="abstract"><strong>Results:</strong> Average time in cast for supracondylar fracture group was 31.8 days and distal forearm fracture group was 32.4 days. The elbow total flexion angle reached a plateau of 139 degrees at 1month after cast removal whereas forearm group required less than 2 weeks. Total rotation ROM required half the time to reach 139 degrees in forearm group. From the paired t test it took more time for pronation to recover than supination in supracondylar fractures. In supracondylar group there was positive correlation between casting period and recovery period of ROM-95 elbow extension (p=0.021) and days of casting (p=0.021) and ROM-95 flexion recovery period. There was no statistically significant impact between casting and recovery period in other directions and recovery of ROM-95 &amp; F-ROM and the subclassification and type of treatment of individual fractures.</p><p class="abstract"><strong>Conclusions:</strong> Lessons learned: thorough assessment of elbow function post cast removal, lack of need of physiotherapy in management protocol and elbow stiffness is related to initial injury and associated treatment not merely immobilisation.</p>

scholarly journals SUPRACONDYLAR FRACTURE OF HUMERUS;

2012 ◽  
Vol 19 (03) ◽  
pp. 308-311
Author(s):  
WASIM ANWAR ◽  
Mohammad SIRAJ ◽  
NOOR RAHMAN ◽  
Malik Javed Iqbal ◽  
Israr Ahmad ◽  
...  
Keyword(s):  
Closed Reduction ◽  
Supracondylar Fracture ◽  
Cubitus Varus ◽  
Supracondylar Fractures ◽  
Injured Side ◽  
Fractures In Children ◽  
The Mean ◽  
Carrying Angle ◽  
One Year

Objectives: To assess closed reduction by Baumann angle in supracondylar fractures humerus treated by closed reduction andpercutaneous pinning. Material and Methods: This prospective study of 50 patients who presented with displaced supracondylar fracture ofhumerus in children between ages 1-12 years were admitted to Orthopedic and Trauma unit of Hayatabad Medical Complex Peshawar overperiod from January 2008 to July 2009. Closed reduction and percutaneous pinning were performed under general anesthesia and postoperativereduction was assessed by Baumann angle. All patients were followed for one year. Results: Mean age of the patients was 7.02 years± 2.25 SD. Loss of Baumann angle in injured side was range from 2O to 8O. Loss of carrying angle in injured side was range from 3O to 9O. WhenBaumann angle and carrying angle of both sides were compared the mean Baumann angle loss and carrying angle loss were 5.360 ± 2.22 SDand 4.320 ± 1.52 SD respectively. Using Flynn’s criteria 36 (72%) patients out of 50 patients with carrying-angle loss considered to be excellentresults and 14(28%) good results. Neither of the patient developed cubitus varus deformit y after one year of follow-up. Conclusions: Baumannangle of the humerus is a simple and reliable measurement of closed reduction that can be used to predict final carrying angle in supracondylarhumeral fractures in children.

scholarly journals COMPARISON OF TWO METHODS OF FIXATION OF SUPRACONDYLAR FRACTURES OF THE HUMERUS IN CHILDREN

2021 ◽  
Vol 29 (5) ◽  
pp. 263-267
Author(s):  
HENRIQUE MELO NATALIN ◽  
JÉSSICA COLAMARINO SESSA DA SILVA ◽  
JOSÉ BATISTA VOLPON
Keyword(s):  
Kirschner Wire ◽  
Contralateral Side ◽  
Supracondylar Fractures ◽  
Kirschner Wires ◽  
Level Of Evidence ◽  
Results Of Treatment ◽  
Fractures In Children ◽  
Supracondylar Humeral Fractures ◽  
Carrying Angle ◽  
Therapeutic Study

ABSTRACT Objective: To compare the outcomes of the fixation of complete and displaced supracondylar humeral fractures in children with two different Kirschner wire configurations. Methods: The type of fixation was randomized to either crossed (19 cases), or two divergent lateral Kirschner wires (24 cases). The comparison was made six months later between the two treated groups and each group with the non-fractured elbow (clinical alignment, range of motion, Baumann angle, and lateral humeral capitellar angle). Results: 43 children were evaluated (65% boys) with a mean age of six years and five months. The carrying angle (p = 0.94), extension (p = 0.89), and the Flynn´s criteria (p = 0.56) were similar between the groups. The flexion was slightly smaller for the crossed wire group (p = 0.04), but similar to the uninjured side. The Baumann angle was not different between the two fixations (p = 0.79) and the contralateral side (p = 0.1). The lateral humeral capitellar angle was slightly greater for the lateral pinning (p = 0.08), but with no difference with the uninjured elbow (p = 0.62). No iatrogenic injuries were observed. Conclusion: Both fixations presented similar outcomes that did not significantly affect the carrying angle in relation to the non-fractured side. Level of evidence II, Therapeutic study - Investigating the results of treatment.

scholarly journals Clinical and functional outcomes of Lambrinudi arthrodesis for correcting fixed equinus deformity

2018 ◽  
Vol 12 (2) ◽  
pp. 159-163
Author(s):  
José Antônio Ribeiro Muniz Filho ◽  
Cleber Jesus Pereira ◽  
Eduardo Gomes Espinosa ◽  
Flávio Malagoli Buiatti ◽  
Rafael Teixeira Fernandes ◽  
...  
Keyword(s):  
Postoperative Period ◽  
Functional Outcomes ◽  
Case Series ◽  
Functional Improvement ◽  
Level Of Evidence ◽  
Charcot Marie Tooth Disease ◽  
Significant Correction ◽  
The Mean ◽  
Equinus Deformity ◽  
The Difference

Objective: To evaluate the clinical and functional outcomes of correction of fixed equinus deformity by Lambrinudi arthrodesis. Methods: Eight patients with fixed equinus deformity were retrospectively assessed. Of these patients, three cases developed secondary to Charcot-Marie-Tooth disease, and five cases developed secondary to fibular nerve injury following trauma. All patients underwent Lambrinudi arthrodesis using the open technique, and functional improvement was analysed postoperatively. The mean age of the patients was 27 years and six months, and six patients were men. Results: The results were evaluated using the ankle and hindfoot score of the American Orthopedic Foot and Ankle Society (AOFAS) scale. The mean score in the postoperative period was 61.71 points, ranging from 41 to 74 points. The difference in the tibia-ground angle in the pre- and postoperative period was measured, and there was a significant correction of this angle. Conclusion: The outcomes of Lambrinudi arthrodesis in patients with fixed equinus deformity were satisfactory concerning the improvement of pain, gait, a high degree of correction of the deformity according to the difference in the tibia-ground angle between the pre- and postoperative period, and preservation of the ankle joint. Level of Evidence IV; Therapeutic Studies; Case Series.

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