scholarly journals Epidemiology Of Proximal And Diaphyseal Humeral Fractures In Children: An Observational Study From The Swedish Fracture Register

2021 ◽  
Author(s):  
Sarah Daag Jacobsen ◽  
Richard Marsell ◽  
Olof Wolf ◽  
Yasmin D. Hailer
Keyword(s):  
Observational Study ◽  
Injury Mechanism ◽  
Humeral Fractures ◽  
Common Mechanism ◽  
Diaphyseal Fracture ◽  
Horse Riding ◽  
Fractures In Children ◽  
Surgical Methods ◽  
Fracture Register ◽  
Diaphyseal Fractures

Abstract Background: Most fractures in children are fractures of the upper extremity. Proximal and diaphyseal humeral fractures account for a minority of these fractures. To our knowledge, few previous reports address these fractures. This study aimed to describe the epidemiology and current treatment of proximal and diaphyseal humeral fractures by using the Swedish Fracture Register (SFR). Methods: In this nationwide observational study from the SFR we analysed data on patient characteristics, injury mechanism, fracture classification and treatment. We included patients aged <16 years at time of injury with proximal or diaphyseal humeral fracture registered in 2015-2019.Results: 1996 (1696 proximal and 300 diaphyseal) fractures were registered. Proximal fractures were more frequent in girls whereas diaphyseal fractures were more frequent in boys. The median age at fracture was 10 years in both fracture types but patient’s age was more widespread in diaphyseal fracture (IQR 5-13 compared to IQR 7-12 in proximal). In both sexes, the most registered injury mechanism was fall. Horse-riding was a common mechanism of injury in girls, whereas ice-skating and skiing were common mechanisms in boys. The majority of fractures were treated non-surgically (92% of proximal and 80% of diaphyseal fractures). The treatment method was not associated with the patient’s sex. Surgery was more often performed in adolescents. The most common surgical methods were K-wire and cerclage fixation in proximal fracture and intramedullary nailing in diaphyseal fracture.Conclusion: Following falls, we found sex-specific sport activities to cause most proximal and diaphyseal paediatric fractures. Further studies on prophylactic efforts in these activities are needed to investigate whether these fractures are preventable. The majority of the fractures were treated non-surgically, although surgical treatment increased with increasing age in both sexes.

scholarly journals Plate Fixation for Irreducible Proximal Humeral Fractures in Children and Adolescents—A Single-Center Case Series of Six Patients

Children ◽  
2021 ◽  
Vol 8 (8) ◽  
pp. 635
Author(s):  
Florian Freislederer ◽  
Susanne Bensler ◽  
Thomas Specht ◽  
Olaf Magerkurth ◽  
Karim Eid
Keyword(s):  
Closed Reduction ◽  
Biceps Tendon ◽  
Plate Fixation ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Constant Murley Score ◽  
Fractures In Children ◽  
Initial Surgery ◽  
Conjoint Tendon

Background: Recommended treatment for severely displaced proximal humeral fractures in children is the closed reduction and percutaneous fixation by K-wires or intramedullary nailing. Methods: From January 2016 to January 2017 6, 21 children/adolescents (range 8 to 16 years) with proximal humeral fractures were treated surgically for severe displacement. In these six patients, several attempts of closed reduction were unsuccessful, and an open reduction was performed. The humeral head was fixed with a 3.5 mm T-plate without affecting the growth plate. Plate removal was performed at a mean interval of 132 days after initial surgery. Two years after initial surgery, the clinical outcome was assessed by the Constant–Murley score and QuickDASH score (including sport/music and work) and the shoulder joint was evaluated with a standardized sonographic examination for the rotator cuff and the conjoint tendon. Results: In all six patients, dorsal displacement of the fracture was irreducible due to the interposition of tendinous or osseous structures. Intraoperatively, the interposed structures were the long biceps tendon in two, periosteal tissue in two, a bony fragment in one, and the long biceps tendon together with the conjoint tendon in one case. At mean follow-up of 26 months (range 22 months to 29 months), patients showed very good clinical results with an excellent mean Constant–Murley score of 97.5 (range 91 to 100) and mean QuickDASH score (including sport/music and work) of 5.5 (range 0–20.8). An X-ray follow-up 6 weeks after surgery demonstrated early consolidation and correct alignment in all patients. A sonographic evaluation at 2 years post injury showed that the biceps and the conjoined tendon were intact in all patients. Conclusions: If a proximal humeral fracture is not reducible by closed means, a tissue entrapment (most likely biceps tendon) should be considered. Treatment with an open reduction and plate fixation yields very good clinical and radiological results and preserves interposed structures as the biceps and conjoint tendon.

scholarly journals Functional outcome of diaphyseal fractures of forearm in adolescents treated with TENS

2019 ◽  
Vol 5 (3) ◽  
pp. 69
Author(s):  
Divyanshu Goyal ◽  
S. L. Sharma ◽  
Laxmikant Meena ◽  
Ravindra Lamoria ◽  
Mahesh Bansal
Keyword(s):  
Range Of Motion ◽  
Functional Outcome ◽  
Case Series ◽  
Age Group ◽  
Forearm Fractures ◽  
Retrospective Case ◽  
Superficial Infection ◽  
Fractures In Children ◽  
Case Series Study ◽  
Diaphyseal Fractures

<p class="abstract"><strong>Background:</strong> A retrospective case series study was done on forearm diaphyseal fracture in adolescents treated with TENS (titanium elastic nailing system). Purpose of the study was analysis of functional outcome of TENS in forearm diaphyseal fractures in children between 12-18 year age group.</p><p class="abstract"><strong>Methods:</strong> We retrospectively evaluated 30 patients operated by same senior surgeon during the period from March 2014 to February 2015 with closed diaphyseal forearm fractures in age group 12–18 years treated with TENS in whom closed reduction could not be achieved. Nail diameter taken as 33-40% of narrowest diameter of diaphysys were introduced proximally in ulna and distally in radius under image intensifier in closed manner. Postoperatively, patients encouraged for active shoulder, elbow and finger movements and suture removal done after 2 weeks. Patients were followed up for minimum period of one year.  </p><p class="abstract"><strong>Results:</strong> In terms of union and range of motion using Anderson et al criteria 24 patients had excellent results, 4 patients had satisfactory results and one patient had poor result having non-union of ulna. Two patients had superficial infection at the nail entry site which eventually resolved. One patient lost for follow up.</p><p class="abstract"><strong>Conclusions:</strong> We conclude that TENS in both bone forearm fractures in adolescent age group in terms of union and range of motion is a minimally invasive and effective method of fixation.</p>

scholarly journals Study of management of diaphyseal fracture shaft femur by intramedullary interlocking nail

2019 ◽  
Vol 5 (4) ◽  
pp. 588
Author(s):  
Ayush Tiwari ◽  
Sarabjeet Singh Kohli ◽  
Manish Kokne
Keyword(s):  
Primary Treatment ◽  
Rotational Stability ◽  
Diaphyseal Fracture ◽  
Flexion Deformity ◽  
Interlocking Nail ◽  
Medical College ◽  
Diaphyseal Fractures ◽  
Free Function ◽  
Femur Shaft

<p class="abstract"><strong>Background:</strong> Aim of this study was to analyze the effectiveness of interlocking nail in management of femoral diaphyseal fractures with special reference to fracture anatomy, pattern and status of stability.</p><p class="abstract"><strong>Methods:</strong> This hospital based prospective study was done in the department of Orthopedics, MGM Medical College Navi Mumbai. A total of 41 patients who were admitted in our institute was included to evaluate management of diaphyseal fracture shaft femur by intramedullary interlocking nail from July 2015 to July 2017. They were asked to follow up at 6 weeks, 3 months and 6 months.<strong></strong></p><p class="abstract"><strong>Results:</strong> Most of the fractures (70.7%) were united in 16-20 weeks while 10 (24.4%) fractures were united in 10-15 weeks and 2 (4.9%) fractures were united in 21-25 weeks. The mean time to union was 16.87±3.09 weeks. In the present study, 26 out of 41 patients had excellent results (63.4%) with full, pain free, function of the extremity. 13 patients with good result (31.8%), 9 patients had flexion deformity 1200, 3 patients had shortening 2 cm, 2 patients had shortening 1 cm. Two patients with fair result (4.8%), both had flexion deformity and none had with poor result. So overall, we had 95.2% excellent to good and 4.8% fair results.</p><p class="abstract"><strong>Conclusions:</strong> Interlocking intramedullary nailing is the most effective ad successful method of definitive primary treatment, in most types of fractures of femur shaft. It provides strong fixation, rotational stability and earliest return to functional status, as rate of healing is good with nailing.</p>

scholarly journals A Single Retrograde Intramedullary Nail Technique for Treatment of Displaced Proximal Humeral Fractures in Children

2021 ◽  
Vol 6 (1) ◽  
pp. e20.00119
Author(s):  
Eleftheria Samara ◽  
Benjamin Tschopp ◽  
Barbara Kwiatkowski ◽  
Elif Vardar ◽  
Nicolas Lutz ◽  
...  
Keyword(s):  
Intramedullary Nail ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Retrograde Intramedullary Nail ◽  
Fractures In Children

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>

Intraoperative radiation exposure in displaced supracondylar humeral fractures: a comparison of surgical methods

2007 ◽  
Vol 16 (1) ◽  
pp. 44-47 ◽  
Author(s):  
Ralf Kraus ◽  
Alexander Joeris ◽  
Christoph Castellani ◽  
Annelie Weinberg ◽  
Theddy Slongo ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Humeral Fractures ◽  
Intraoperative Radiation ◽  
Surgical Methods ◽  
Supracondylar Humeral Fractures

Humeral Fractures Without Obvious Etiologies in Children Less Than 3 Years of Age: When Is It Abuse?

PEDIATRICS ◽  
1995 ◽  
Vol 96 (4) ◽  
pp. 667-671
Author(s):  
Richard T. Strait ◽  
Robert M. Siegel ◽  
Robert A. Shapiro
Keyword(s):  
Medical Center ◽  
Retrospective Chart Review ◽  
Humeral Fracture ◽  
Humeral Fractures ◽  
Supracondylar Fractures ◽  
Fractures In Children ◽  
Arm Injuries ◽  
Made In

Objective. To determine the occurrence and frequency of abuse in children with humeral fractures without immediately obvious etiologies who are less than 3 years old and present with arm injuries. Methods. A retrospective chart review was conducted of all children less than 3 years old treated for a humeral fracture at Children's Hospital Medical Center between July 1, 1990, and September 10, 1993. One hundred twenty-four charts of children with humeral fractures were reviewed for possible abuse using previously developed criteria. Charts were evaluated independently by the investigators. Consensus was reached on classification of each chart into the following categories: abuse, indeterminate, or not abuse. Results. Abuse was diagnosed in 9 of 25 (36%) children less than 15 months of age, but in only 1 of 99 (1%) children older than 15 months (P &lt; .05). Abuse was excluded in 91 of 124 (73%) children. No determination of abuse (indeterminate) could be made in 23 of 124 (18.5%) children. In children less than 15 months of age, abuse was diagnosed in 2 of 10 (20%) with supracondylar fractures and in 7 of 12 (58%) with spiral/oblique fractures. Conclusion. The prevalence of abuse in our children presenting with humeral fractures was much lower than in other published reports, especially in the children over the age of 15 months. However, we found a higher prevalence of supracondylar fractures associated with abuse than those same reports. Given these findings, abuse should be considered in all children less than 15 months of age with humeral fractures, including those with supracondylar fractures. The majority of humeral fractures in children are accidental, especially beyond the age of 15 months.

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