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 Variations in situational risk factors for fractures of the distal forearm, hip, and vertebrae in older women

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wen-Yu Yu ◽  
Hei-Fen Hwang ◽  
Mau-Roung Lin
Keyword(s):  
Risk Factors ◽  
Soft Tissue ◽  
Older Women ◽  
Individual Characteristics ◽  
Situational Factors ◽  
Control Group ◽  
Distal Forearm ◽  
Forearm Fractures ◽  
Protective Response ◽  
Distal Forearm Fractures

Abstract Background Situational factors during a fall among three common types of fractures of the distal forearm, hip, and vertebrae among older women in Taiwan were investigated. Methods In 2016 ~ 2017, study participants were identified from those aged ≥65 years who visited emergency departments due to a fall in two university-affiliated hospitals in Taipei. In addition to individual characteristics, situational factors during the fall (location, activity, change of center of mass, fall mode, fall direction, initiating a protective response, and being hit) were collected. A sample of 203 distal-forearm fractures, 189 vertebral fractures, and 375 hip fractures was recruited, while 717 women with a soft-tissue injury were used as a control group. The identification of situational risk factors for each type of fracture was validated by using those who sustained one of the other two types of fracture as a control group. Results After adjusting for age and other individual characteristics, compared to soft-tissue injuries, distal-forearm fractures were significantly more likely to occur with slips (odds ratio [OR] = 11.0; 95% confidence interval [CI] = 4.76 ~ 25.4), trips (OR = 3.40; 95% CI = 1.42 ~ 8.17), step-downs (OR = 4.95; 95% CI = 2.15 ~ 11.4), and from sideways falls (OR = 1.73; 95% CI = 1.12 ~ 2.67) and significantly less likely to occur indoors (OR = 0.62; 95% CI = 0.42 ~ 0.90) or from backwards falls (OR = 0.62; 95% CI = 0.41 ~ 0.95). Hip fractures were significantly more likely to occur with step-downs (OR = 1.76; 95% CI = 1.13 ~ 2.75) and from backwards (OR = 3.16; 95% CI = 2.15 ~ 4.64) or sideways falls (OR = 5.56; 95% CI = 3.67 ~ 8.41) and significantly less likely when hitting an object (OR = 0.26; 95% CI = 0.13 ~ 0.52) or initiating a protective response (OR = 0.58; 95% CI = 0.36 ~ 0.93). Vertebral fractures were significantly more likely to occur with slips (OR = 2.42; 95% CI = 1.30 ~ 4.50), step-downs (OR = 2.53; 95% CI = 1.43 ~ 4.48), and backwards falls (OR = 2.15; 95% CI = 1.39 ~ 3.32). Similar results were found in the validation analyses. Conclusions Large variations in situational risk factors for the three types of fracture in older women existed. A combination of individual and situational risk factors may display a more-comprehensive risk profile for the three types of fracture, and an intervention that adds training programs on safe landing strategies and effective compensatory reactions may be valuable in preventing serious injuries due to a fall.

Plaster cast treatment for distal forearm fractures in children

2020 ◽  
Vol 29 (2) ◽  
pp. 179-186
Author(s):  
Domenico Ravier ◽  
Ilaria Morelli ◽  
Valentina Buscarino ◽  
Chiara Mattiuz ◽  
Luca M. Sconfienza ◽  
...  
Keyword(s):  
Plaster Cast ◽  
Distal Forearm ◽  
Forearm Fractures ◽  
Fractures In Children ◽  
Distal Forearm Fractures

Point-of-care ultrasound compared with conventional radiographic evaluation in children with suspected distal forearm fractures in the Netherlands: a diagnostic accuracy study

2019 ◽  
Vol 36 (10) ◽  
pp. 613-616 ◽  
Author(s):  
Anniek C Epema ◽  
Mariëlle J B Spanjer ◽  
Lieselotte Ras ◽  
Johannes C Kelder ◽  
Marieke Sanders
Keyword(s):  
The Netherlands ◽  
Diagnostic Accuracy ◽  
Conventional Radiography ◽  
Point Of Care Ultrasound ◽  
Distal Forearm ◽  
Forearm Fractures ◽  
Predictive Values ◽  
Pain Scores ◽  
Fractures In Children ◽  
Distal Forearm Fractures

BackgroundDistal forearm fractures are common in children. The reference standard to diagnose these fractures is by conventional radiography, which exposes these patients to harmful radiation. Ultrasound (US) seems to be a good alternative. However, emergency physicians (EPs) in the Netherlands have limited experience in using US for diagnosing fractures in children.ObjectiveThe primary objective was to determine the accuracy of US, performed by a Dutch EP, compared with conventional radiography, in diagnosing distal forearm fractures in children. As a secondary objective, differences in pain scores during the performance of both US and plain radiography were determined.MethodsChildren, aged between 0 and 14 years old, suspected of having a distal forearm fracture were enrolled at the Emergency Department. US and radiographic findings were compared. Statistics for accuracy were calculated. Pain scores were recorded during US and radiography and compared as well. All participating operators received an hour-long pretrial training.Results100 patients were enrolled. The mean age was 9.5 years (SD, 3.6), and 50% were women. Overall diagnostic accuracy was 92% (95% CI 85%-96%). The sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios for US were 95% (95% CI 87% to 99%), 86% (95% CI 71% to 95%), 92% (95% CI 83% to 97%), 91% (95% CI 76% to 98%), 6.86 (95% CI 3.04 to 15.51) and 0.05 (95% CI 0.02 to 0.17), respectively. The pain scores during US and radiographic imaging were 3.3 and 4.6, respectively (p<0.01).ConclusionsIn this study, we showed that US is an accurate method for diagnosing distal forearm fractures in children. The main advantages are that it is radiation-free and rapidly practicable, and that patients experience it as less painful than radiography. Moreover, this study has proven that with minimal experience in US, good diagnostic accuracy can be achieved after brief training.

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