Surgical Interventions for the Treatment of Supracondylar Humerus Fractures in Children: Protocol of a Systematic Review

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

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Trampoliny – czy są bezpieczne? Skoki na batucie jako przyczyna urazów narządu ruchu w materiale dziecięcego oddziału urazowo-ortopedycznego

Medycyna Rodzinna ◽

10.25121/mr.2019.22.1.3 ◽

2019 ◽

Vol 22 (1) ◽

Author(s):

Piotr Zając

Keyword(s):

Distal Tibia ◽

Severe Injuries ◽

Locomotor System ◽

Surgical Interventions ◽

Number Of Children ◽

Risk Of Injury ◽

Limb Injuries ◽

Supracondylar Humerus Fractures ◽

Forearm Bones ◽

Humerus Fractures

Introduction. Skilful marketing and accessible prices are main causes of popularity of garden trampolines. Increasingly often the improper and unwise use of them leads to severe injuries of the locomotor system. Aim. An analysis of the above-mentioned injuries in children using materials of the Orthopaedics and Trauma Unit. Material and methods. Using the hospital IT system emergency admittances were analysed for the years 2016-2017. A selected group of patients was evaluated in terms of epidemiology and treatment methods. Results. Treatment was provided to 41 patients (21 boys, 20 girls), aged 2 to 16 years (mean age: 7.3 years). 85.4% of the admitted patients used the trampoline together with other children, 70.7% children bounced on the trampoline unsupervised by adults. Upper limb injuries represented 82.9% (34 children) of all cases, the majority of injuries involved the elbow joint and the forearm. Supracondylar humerus fractures and fractures of the shaft of both forearm bones were most frequently diagnosed. Lower limb injuries represented 17.1% (7 children) of all cases, related to the knee joint and ankle area, the most frequently diagnosed injuries were distal tibia and fibula fractures. Twenty eight (68.3%) children required surgical treatment, and 13 (31.7%) patients received conservative treatment. Conclusions. There are a growing number of children with locomotor system injuries related to playing on a trampoline and requiring hospitalisation and surgical interventions. Own experience and quoted references allow formulating principles reducing the risk of injury, including prohibiting the youngest children to play, reduction of the simultaneous use of a trampoline by more than one child, and a requirement of a constant supervision.

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Screw fixation for supracondylar humerus fractures in children: a report of seventeen cases

European Journal of Orthopaedic Surgery & Traumatology ◽

10.1007/s00590-018-2316-6 ◽

2018 ◽

Vol 29 (3) ◽

pp. 575-581 ◽

Cited By ~ 1

Author(s):

Sherif Dabash ◽

Chris Gerzina ◽

Gautham Prabhakar ◽

Ahmed M. Thabet ◽

Soyoung Jeon ◽

...

Keyword(s):

Screw Fixation ◽

Fractures In Children ◽

Supracondylar Humerus Fractures ◽

Humerus Fractures

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Dislocated Extension – Type Supracondylar Humerus Fractures in Children: Single Centre Experience

Macedonian Journal of Medical Sciences ◽

10.3889/mjms.1857-5773.2013.0339 ◽

2014 ◽

Vol 7 (1) ◽

pp. 29-33

Author(s):

Lazar Todorovic ◽

Keyword(s):

Single Centre ◽

Fractures In Children ◽

Single Centre Experience ◽

Supracondylar Humerus Fractures ◽

Humerus Fractures

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Fixation of Type 2a Supracondylar Humerus Fractures in Children With a Single Pin

Journal of Pediatric Orthopaedics ◽

10.1097/bpo.0000000000000247 ◽

2014 ◽

Vol 34 (8) ◽

pp. e54-e57 ◽

Cited By ~ 3

Author(s):

Alexander J. Kish ◽

William L. Hennrikus

Keyword(s):

Fractures In Children ◽

Supracondylar Humerus Fractures ◽

Humerus Fractures

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Close Reduction Percutaneous Pinning (CRPP) versus Open Reduction Internal Fixation (ORIF) for Pediatric Supracondylar Humerus Fractures Gartland Type II and III: A Systematic Review and Meta-analysis

Journal Of The Indonesian Medical Association ◽

10.47830/jinma-vol.71.4-2021-389 ◽

2021 ◽

Vol 71 (4) ◽

pp. 187-193

Author(s):

Putu Astawa ◽

Made Agus Maharjana ◽

Surya Adisthanaya ◽

Made Winatra Satya Putra ◽

Agus Suarjaya Putra ◽

...

Keyword(s):

Systematic Review ◽

Case Reports ◽

Meta Analysis ◽

Fixed Effect Model ◽

Cosmetic Outcome ◽

Type I ◽

Type Ii ◽

Supracondylar Humerus Fractures ◽

Significant Difference ◽

Humerus Fractures

Introduction: Displaced supracondylar fracture in children is a challenging injury that may result in impaired functional and cosmetic outcome if not well-treated. Utilization of Closed Reduction and Percutaneus Pinning (CRPP) increased for this pathology, some authors believe ORIF results better anatomical reduction and lower rate of loss of reduction. Study aims to compare CRPP and ORIF for pediatric supracondylar humerus fracture. Method: Systematic review was conducted based on PRISMA guideline. Inclusion criteria were age <18 years old, comparing CRPP and ORIF for Supracondylar Humerus Fractures Gartland Type II, II.Studies of one surgical technique, Gartland type I, case reports were excluded. For meta-analysis, 6 studies were included and fixed effect model used to pool the result. In each study, mean difference (MD) with 95% confidence interval (CI) was calculated for dichotomous outcomes using Review Manager. Result: Total of 252 patients aged 0-15 years old were included. CRPP more often performed than ORIF. Satisfactory outcomes measured by Flynn’s criteria were achieved in 87.74% in CRPP and 86.73% in ORIF patient group, indicating significant difference (Heterogeneity, I2 = 23%; WMD, 1.26; 0.58 to 2.73; P =0.56). Conclusion: Current systematic review and meta-analysis suggest that for displaced supracondylar humerus fractures, ORIF offers a comparable functional and cosmetic outcome compared to CRPP.

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