scholarly journals Delay increases the need for open reduction of type-III supracondylar fractures of the humerus

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
Keyword(s):  
Open Reduction ◽  
Supracondylar Fractures ◽  
Type Iii

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 Type-III supracondylar humerus fracture: functional outcome of open reduction and internal fixation after failed closed reduction

2020 ◽  
Vol 7 (1) ◽  
pp. 62
Author(s):  
Shobha H. P. ◽  
Vishwas K. ◽  
Lingaraju K. ◽  
Giridhar Kumar
Keyword(s):  
Internal Fixation ◽  
Closed Reduction ◽  
Open Reduction ◽  
Supracondylar Fractures ◽  
Orthopaedic Department ◽  
Type Iii ◽  
Medical College ◽  
K Wires ◽  
Age Range

<p><strong>Background: </strong>To evaluate results of open reduction and internal fixation with Criss cross k-wires after failed closed reduction in Gartland type III Supracondylar fracture of humerus in our institution.<strong></strong></p><p><strong>Methods:</strong> This prospective study was conducted at the Krishna Rajendra hospital affiliated to the orthopaedic department of Mysore medical college and research institute from December 2018 to December 2019. Twenty-five patients of type-III fracture of supracondylar humerus were included within the study. Consent was obtained from all patients. Under anaesthesia, closed reduction was attempted first. When 2-3 attempts of closed reduction failed, an open reduction and internal fixation with cross k-wires was performed. Fortnightly follow up was applied for the first 8 weeks then monthly for the next 4 months. The clinical outcome was evaluated using Flynn criteria.</p><p><strong>Results:</strong> Out of 25 patients, 16 were male and 9 were female. Left side was involved in 17 patients and right side in 8. Mean age was 6.9 years with age range from 3 to 12 years. Excellent or good results were obtained in 23 (92%) patients and fair or poor in 2 (8%). </p><p><strong>Conclusions:</strong> We conclude that these fractures must be managed aggressively, by a specialised surgeon. Open reduction and internal fixation of severely displaced supracondylar fractures of the humerus is a safe and effective method when a satisfactory reduction can't be obtained by 2-3 attempts on closed method.</p>

scholarly journals Open Reduction and Internal Fixation of Supracondylar Fractures of the Humerus: Revival of the Anterior Approach

2011 ◽  
Vol 51 (182) ◽  
Author(s):  
R R Manandhar ◽  
S Lakhey ◽  
B K Pandey ◽  
R L Pradhan ◽  
S Sharma ◽  
...  
Keyword(s):  
Open Reduction ◽  
Anterior Approach ◽  
Supracondylar Fractures ◽  
Radiological Criteria ◽  
Clinical Criteria ◽  
Type Iii ◽  
Direct Exposure ◽  
Paediatric Age ◽  
K Wires ◽  
Neurovascular Structures

Introduction: Supracondylar fractures of the humerus occur commonly in the paediatric age group. Gartland type III fractures are treated by closed manipulation and percutaneous pinning with K-wires. Open reduction is indicated in open fractures, failed closed reductions and in a dysvascular limb. There are various approaches that can be utilized to perform an open reduction. The approach of choice must be safe, surgeon and patient friendly and should provide a good access to the fracture and the important surrounding structures. The anterior approach has been described as the most versatile approach. The aim of the study was to review the advantages and drawbacks of the anterior approach and to assess the functional outcome of fractures treated via this approach.  Methods: Twenty ve (15 male and 10 female) patients out of a hundred and twenty eight children with Gartland type III extension variety of supracondylar fractures of the humerus from underwent open reduction and internal xation with K-wires via an anterior approach January 2007 to January 2011. The results were assessed at six months using Flynn’s radiological and clinical criteria. Results: Twenty ve patients (19.53%) out of hundred and twenty eight patients underwent open reduction and internal xation. According to Flynn’s clinical and radiological criteria, 20 (80%) were found to have excellent and 5 (20%) good results.  Conclusion: The anterior approach is safe, easy and provides direct exposure of the surrounding neurovascular structures with good to excellent results.  Keywords: anterior approach, open reduction, supracondylar fractures humerus.   

scholarly journals Functional Outcomes of Close Pinning and Open Reduction in Pediatric Gartland Type III Supracondylar Fractures: a Comparison

2019 ◽  
Vol 06 & 06h (1) ◽  
Author(s):  
Mohsen Khorrami ◽  
◽  
Ahmad Dashtbozorg ◽  
Mohammadali Ghassemi ◽  
Amir Khorrami ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Open Reduction ◽  
Supracondylar Fractures ◽  
Type Iii

scholarly journals Complications in type III open tibial shaft fractures treated with open reduction and internal fixation

2019 ◽  
Vol 8 (11) ◽  
pp. 907-915
Author(s):  
Abhishek S Chitnis ◽  
Mollie Vanderkarr ◽  
Charisse Sparks ◽  
Jonathan McGlohorn ◽  
Chantal E Holy
Keyword(s):  
Internal Fixation ◽  
Generalized Linear Models ◽  
Open Reduction ◽  
Linear Models ◽  
Emergency Room Visit ◽  
Tibial Shaft ◽  
Type Iii ◽  
Healthcare Burden ◽  
Shaft Fractures ◽  
Tibial Shaft Fractures

Aim: To estimate rates of fracture-related infection (FRI) and nonunion and assess the healthcare burden associated with FRI among patients with open reduction and internal fixation (ORIF) for Type III open tibial shaft fractures (TSFs). Methods: Patients with type III TSF requiring ORIF were identified using MarketScan® Database. Healthcare utilization and total costs were compared using generalized linear models. Results: The rates of FRI and nonunion were 35.99 and 36.94%, respectively, at 365 days. Patients with FRI had a significantly higher rate of readmission, emergency room visit and total healthcare costs compared with patients without FRI. Conclusion: Patients with an ORIF procedure for Type III TSF have a high risk of FRI and nonunion and; FRI significantly increased the healthcare burden.

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
Keyword(s):  
Open Reduction ◽  
Supracondylar Fractures

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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