scholarly journals Closed pinning for paediatric supracondylar fractures: does timing really matter?

2017 ◽  
Vol 3 (3) ◽  
pp. 417
Author(s):  
Suresh Babu Surapaneni ◽  
Ravi Kiran Kopuri ◽  
Venkata Suresh Babu Tummala
Keyword(s):  
Closed Reduction ◽  
Nerve Palsy ◽  
Radial Nerve Palsy ◽  
Radial Pulse ◽  
Supracondylar Fractures ◽  
Average Delay ◽  
Median Nerve Palsy ◽  
Ulnar Nerve Palsy ◽  
Pin Fixation ◽  
Group 2

<p><strong>Background:</strong> Management guidelines and comparative studies are not yet clear for those patients who present early and late with widely displaced supracondyle humerus fracture in children.</p><p><strong>Methods:</strong> A total of 74 children were included in this study, 30 patients presenting early within 24 hours as group 1, and 44 patients who presented late i.e. after 24 hours and within a week as group 2 underwent closed reduction and pinning.<strong></strong></p><p><strong>Results: </strong>In group one 24 had excellent, 6 had good results, according to modified Flynn’s criteria. One patient developed ulnar nerve palsy which was iatrogenic, and improved completely after wire removal. Another was brachial artery injury which was explored and recovered completely. In group 2 the average delay in presentation was 57.56 hours; mean time to surgery after presentation was 9.83 hours. Sixteen patients (36.36%) had neurologic complications at presentation to the emergency room of which three had median nerve palsy (6.81%) whereas seven (15.90%) had isolated anterior interosseous nerve palsy and six (13.6%) had radial nerve palsy all patients showed total neurological recovery at 12 weeks. Six patients (13.63%) had vascular compromise at initial presentation of which five patients had feeble radial pulse and one had absent radial pulse, but capillary filling was adequate in all. The pulse was restored within 24 hours in all patients following reduction. There were 37 excellent, 6 good and 1fair results.</p><p><strong>Conclusions:</strong> Our results support, closed reduction and Percutaneous pin fixation as an effective treatment option for grossly displaced supracondylar fractures presenting early and late but requires good and careful judgment and also technique.</p>

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.

SPLINTING FOR PERIPHERAL NERVE INJURY IN UPPER LIMB

Hand Surgery ◽  
2002 ◽  
Vol 07 (02) ◽  
pp. 251-259 ◽  
Author(s):  
Rebecca K. Y. Chan
Keyword(s):  
Peripheral Nerve ◽  
Nerve Palsy ◽  
Injury Severity ◽  
Nerve Repair ◽  
Hand Function ◽  
Radial Nerve Palsy ◽  
Joint Contractures ◽  
Median Nerve Palsy ◽  
Ulnar Nerve Palsy ◽  
Severity Of Injury

The prognosis and speed of peripheral nerve recovery depend very much on the level of injury, severity of injury, the surgical intervention and the subsequent rehabilitative process. Many high level injuries may take years or months for the affected peripheral nerve to recover. Prolonged muscle imbalance causes joint contractures and over-stretching of denervated muscles. Without proper care, hand function recovery may be limited even the nerve regenerated afterwards. During the nerve regeneration period, splinting is one of the most useful modality to minimise deformities, prevent joint contractures and substitute loss motor control. Proper splinting encourages early use of the injured hand in daily activities. There are different types of splinting design for median nerve palsy, ulnar nerve palsy and radial nerve palsy. Dynamic splinting techniques are frequently employed to allow early prehension activities. Other therapeutic techniques, including pressure garment and sensory re-education are useful to enhance better functional return after nerve repair.

Neurological

2019 ◽  
pp. 109-186
Author(s):  
Tanya M. Monaghan ◽  
James D. Thomas
Keyword(s):  
Nerve Palsy ◽  
Cauda Equina ◽  
Radial Nerve Palsy ◽  
Pseudobulbar Palsy ◽  
Subacute Combined Degeneration ◽  
Charcot Marie Tooth Disease ◽  
Tabes Dorsalis ◽  
Median Nerve Palsy ◽  
Ulnar Nerve Palsy ◽  
Muscles Of The Hand

This chapter concerns neurological medicine, and covers dermatomes, peripheral nerves and tendon reflexes, peripheral neuropathy, hemiplegia, myotonic dystrophy, proximal myopathy, motor neurone disease, cerebellar syndrome, myasthenia gravis, cervical myelopathy, median nerve palsy, ulnar nerve palsy, radial nerve palsy, wasting of the small muscles of the hand, syringomyelia, polymyositis, Parkinson’s disease, Friedreich’s ataxia, Charcot–Marie–Tooth disease, subacute combined degeneration of the cord, tabes dorsalis, cerebellopontine angle syndrome, paraplegia, visual field defect, nerve palsy, nystagmus, Horner’s syndrome, ptosis, large pupil, small pupil, Holmes–Adie–Moore syndrome, Argyll Robertson pupil, internuclear ophthalmoplegia, facial palsy, bulbar palsy, pseudobulbar palsy, and cauda equina syndrome.

Prevalence of ulnar nerve palsy with flexion-type supracondylar fractures of the humerus

2020 ◽  
Vol 29 (2) ◽  
pp. 133-136 ◽  
Author(s):  
Kelvin Y. Kim ◽  
William Conaway ◽  
Ryan Schell ◽  
William L. Hennrikus
Keyword(s):  
Ulnar Nerve ◽  
Nerve Palsy ◽  
Supracondylar Fractures ◽  
Ulnar Nerve Palsy

Reconstruction after nerve injury

2011 ◽  
Author(s):  
T.E.J. Hems
Keyword(s):  
Nerve Injury ◽  
Tendon Transfer ◽  
Nerve Palsy ◽  
Common Type ◽  
Radial Nerve Palsy ◽  
Reconstructive Procedures ◽  
Tendon Transfers ◽  
Ulnar Nerve Palsy ◽  
Intrinsic Paralysis ◽  
Median Nerve Injury

♦ Late reconstructive procedures may improve function if there is persisting paralysis after nerve injury♦ Transfer of a functioning musculotendinous unit to the tendon of the paralysed muscle is the most common type of procedure♦ Passive mobility must be maintained in affected joints before tendon transfer can be performed♦ The transferred muscle should be expendable, have normal power, and have properties appropriate to the function it is required to restore♦ Tendon transfers can provide reliable improvement in function after isolated radial nerve palsy♦ A number of procedures have been described for reconstruction of thumb opposition but impaired sensation after median nerve injury may limit gain in function♦ Tendon transfers are possible to improve clawing of fingers and lateral pinch of the thumb after ulnar nerve palsy or other cases of intrinsic paralysis.

scholarly journals Displaced supracondylar fractures of the humerus treated by closed reduction with percutaneous pin fixation

2018 ◽  
Vol 4 (2c) ◽  
pp. 169-171
Author(s):  
Dr. Mohammed Irshad Basha A ◽  
Dr. Srinivasan N ◽  
Dr. Vijay Narasimman Reddy
Keyword(s):  
Closed Reduction ◽  
Supracondylar Fractures ◽  
Pin Fixation

scholarly journals Arm-wrestling injuries – A systematic review of the medical literature

2020 ◽  
pp. 1-3
Author(s):  
Renan Felipe Correia ◽  
Alex Natalino Ribeiro ◽  
Roberto Pires de Araújo
Keyword(s):  
Systematic Review ◽  
Popular Culture ◽  
Nerve Palsy ◽  
Medical Literature ◽  
Case Reports ◽  
Medial Epicondyle ◽  
Radial Nerve Palsy ◽  
Ulnar Nerve Palsy ◽  
Correct Technique ◽  
Practice Methods

Background: Arm wrestling is a popular sport due to its simplistic nature and great appeal in popular culture. Unfortunately, it can lead to serious fractures. An understanding of these injuries and its mechanisms is vital to the undertaking of safe practice methods for this sporting modality. Objectives: This study aimed to review articles that demonstrate case reports about arm-wrestling related fractures. Methods: PubMed’s database was searched with the keywords “Arm Wrestling,” Arm-wrestling,” and “Armwrestling.” Ofthe 34 articles found, 11 were fit to compose this review, being grouped into studies that dealt with adults and studies that dealt with adolescents. Results: Of the 63 adult subjects reported, 62 suffered fractures of the distal third of the humerus, occasionally accompanied by butterfly fractures and radial nerve palsy. Of the 22 adolescent subjects reported, 20 suffered fractures of the humerus medial epicondyle, never accompanied by butterfly fractures, and sometimes accompanied by ulnar nerve palsy. All injuries stemmed from unbalanced torsional forces suffered by the humerus from its own musculature. Conclusions: The injury profile presented by both populations is very homogeneous between the two different groups, which leads us to believe that correct technique can be a great ally in arm wrestling injury prevention. Athletes, as well as common practitioners, should be coached as to avoid these unfavorable positions and techniques

scholarly journals Evaluation of Gartland Type-III Closed Supracondylar Fracture of Humerus in Children Treated by Lateral Percutaneous K-Wires under C-Arm Guidance

2021 ◽  
Vol 33 (2) ◽  
pp. 138-142
Author(s):  
Md Insanul Alam ◽  
Sheikh Firoj Kabir ◽  
Md Faridul Islam ◽  
Md Ismail Hossain ◽  
Md Omar Faruque ◽  
...  
Keyword(s):  
Closed Reduction ◽  
Elbow Flexion ◽  
Supracondylar Fracture ◽  
Type Iii ◽  
Median Nerve Palsy ◽  
Pin Fixation ◽  
Number Of Patients ◽  
Quasi Experimental ◽  
Carrying Angle ◽  
K Wires

Introduction: This study has been designed to evaluate the success rate of closed reduction and stabilization by two lateral parallel percutaneous K-wires with the help of C-arm in the management of Gartland type-III closed supracondylar fracture of humerus in children. Materials and Methods: A prospective quasi experimental study was conducted from January 2015 to December 2016 in NITOR. A total of 30 patients of Gartland type-III closed supracondylar fracture of humerus in children presenting between ages 3-12 years. Informed written consent was taken from patient’s guardian. Regular follow up was targeted for at least 6 month’s. Result was evaluated according to Flynn’s grading. Results: Mean age was 6.85± 2.37 years, number of patients ware 30, Male patients were more affected 22 (73.33%) than female 8(26.67%), left side patients were more affected. Mean loss of elbow flexion was 9.53 degrees, mean loss of carrying angle was 8.5 degrees. Complications included four (13.33%) cases of pin tract infection, four (13.33%) cases of fracture blister, one (3.33%) case of median nerve palsy, two (6.66%) cases of inadequate pin fixation at first attempt. There were six excellent (20%), eighteen good (60%), three (10%) fair and three (10%) poor results according to Flynn’s grading. The overall 90% satisfactory result and rest 10% unsatisfactory result. Conclusion: Closed reduction and stabilization by two lateral parallel percutaneous K-wires is a better method for treatment of Gartland type-III closed supracondylar fracture in children. Medicine Today 2021 Vol.33(2): 138-142

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