scholarly journals To compare the functional outcome of cross k-wires v/s lateral k-wires in Gartland type-III supracondylar humerus fracture in paediatric age groups

2018 ◽  
Vol 4 (3.6) ◽  
pp. 601-605
Author(s):  
Dr. Deepak K Aher ◽  
Dr. Rajesh Kumar Mishra ◽  
Dr. Rajesh Jamoria ◽  
Dr. Harendra Singh
Keyword(s):  
Functional Outcome ◽  
Age Groups ◽  
Humerus Fracture ◽  
Supracondylar Humerus Fracture ◽  
Type Iii ◽  
Paediatric Age ◽  
K Wires

scholarly journals Surgical Management of Paediatric Neglected Humeral Supracondylar Fracture: A Series of 3 Cases in 3 Years

2020 ◽  
Vol 18 (2) ◽  
Author(s):  
Kow Ren Yi ◽  
Low Chooi Leng ◽  
Nur Azuatul Akmal Kamaludin ◽  
Aziah Abdul Aziz ◽  
Kamariah Nor Mohd Daud
Keyword(s):  
Open Reduction ◽  
Posterior Approach ◽  
Corrective Osteotomy ◽  
Lateral Approach ◽  
Supracondylar Fracture ◽  
Humerus Fracture ◽  
Supracondylar Humerus Fracture ◽  
Left Elbow ◽  
Right Hand ◽  
K Wires

Introduction: Supracondylar fracture of the humerus is common among paediatric population. In our country, it is not uncommon for patients to present late to the hospital after an injury. Devnani reported a case series of 28 children who sustained supracondylar humerus fracture and presented late (mean 5.6 days) to the hospital. We report our experience in managing 3 patients who presented late (range 15 days to 8 months) with neglected supracondylar humerus fracture in 3 years. Case report: Case 1: A right hand-dominant 5-year-old boy sustained a fall 8 months prior to presentation to the hospital. He was treated with traditional methods immediately after the injury. He presented with malunion of left humeral supracondylar fracture with varus deformity and limited left elbow range of movements. An open reduction (lateral approach) and corrective osteotomy were performed and 2 lateral K-wires were inserted. Case 2: A 10-year-old boy with right hand dominance sustained a closed left supracondylar humerus fracture Gartland 3 after a fall. His parents initially refused any surgical intervention. However, they finally agreed for surgery on day 15 post-trauma. An open reduction (posterior approach) and callus removal were done and 2 crossed K-wires were inserted. Case 3: A right hand-dominant 5year-old girl had history of fall 1 month prior to presentation to the hospital. She was treated with traditional methods initially. She presented with malunion of the left supracondylar humerus fracture with limited range of motion of her left elbow. An open reduction (posterior approach) and corrective osteotomy were performed and 2 crossed K-wires were inserted. Discusssion: Two patients underwent open reduction via the posterior approach and 1 patient via the lateral approach. Only one patient required callus removal while 2 patients required osteoclasis. All patients recovered without complication and there was improved range of movement of the elbows. Conclusion: Surgical intervention is the treatment of choice in managing neglected supracondylar humerus fracture.

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 A study on outcome of various K-wire fixations in paediatric supracondylar humerus fractures

2020 ◽  
Vol 6 (5) ◽  
pp. 896
Author(s):  
Shalin Bharat Shah ◽  
Kushal Nikhil Parikh ◽  
Pradipkumar Ishvarbhai Paraliya
Keyword(s):  
Functional Outcome ◽  
Cosmetic Outcome ◽  
Humerus Fracture ◽  
Supracondylar Humerus Fracture ◽  
Lateral Entry ◽  
Supracondylar Humerus Fractures ◽  
Pin Geometry ◽  
Humerus Fractures ◽  
The Mean

<p class="abstract"><strong>Background:</strong> The ideal pin geometry for treatment of paediatric supracondylar humerus fracture is still debated. Various studies have been carried out comparing medial-lateral pinning (MLP) and lateral only pinning (LOP), but none have compared all three individually i.e. MLP, lateral divergent pinning and Lateral Trans olecranon fossa four cortex purchase pinning (TOF-FCP). This study aims to compare the cosmetic and functional outcome of these three pinning methods.</p><p class="abstract"><strong>Methods:</strong> 54 children with supracondylar humerus (Gartland type 2 or 3) meeting inclusion criteria were treated operatively and followed up till 6 months postoperatively. At 6 months the cosmetic and functional outcomes were assessed using the modified Flynn criteria.<strong></strong></p><p class="abstract"><strong>Results:</strong> All fractures united within 3 to 6 weeks duration. The mean duration of fracture union was 4.05 weeks. Functional outcome was satisfactory (i.e. excellent or good) at 6 months according to Flynn criteria in 95% of cases in cross pinning, 100% cases in TOF-FCP construct and 89% cases in lateral entry divergent pinning. cosmetic outcome was satisfactory (i.e. excellent or good) at 6 months according to Flynn criteria in 95% of cases in cross pinning, 100% cases in TOF-FCP construct and 89% cases in lateral entry divergent.</p><p class="abstract"><strong>Conclusions:</strong> Functional and cosmetic outcome of all three pinning geometries after operative intervention of paediatric supracondylar humerus fracture is similar in expert hands. The incidence of complications with TOF-FCP construct is less amongst the lateral only pinning.</p>

scholarly journals Paratricepital approach for open reduction and internal fixation of delayed presentation of pediatric supracondylar humerus fracture

2019 ◽  
Vol 6 (1) ◽  
pp. 107
Author(s):  
Ramachandra Subbasetty ◽  
Dayanand Manjunath ◽  
Deepak Shivanna ◽  
Narasimha Murthy
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Open Reduction ◽  
Perioperative Complications ◽  
Humerus Fracture ◽  
Delayed Presentation ◽  
Supracondylar Humerus Fracture ◽  
Fractures In Children ◽  
The Mean

<p class="abstract"><strong>Background:</strong> Delayed presentation of pediatric displaced supracondylar humerus fracture is relatively common. Management of such cases have higher incidence of perioperative complications and usually require open reduction and pinning. Open reduction can be done by various approaches, each having its own advantage and disadvantages.</p><p class="abstract"><strong>Methods:</strong> A prospective study was done comprising 20 children with displaced Supracondylar fracture presented 2-14 days of injury, Mean patient age was 6 years. 15 were boys and 5 were girls. Children in whom closed reduction and percutaneous pinning was achieved, vascular injury and more than 2 weeks old fracture cases were excluded. Paratricepital approach was used for Open reduction and pinning for all the cases. The functional outcome was assessed using Flynn criteria.<strong></strong></p><p class="abstract"><strong>Results:</strong> In all cases the fracture had united at complete follow-up and the mean follow-up period was 16 months. The outcome was excellent in 15 (75%), good in 3 (15%), fair in 1 (5%), and poor in 1 (5%) patients. The mean Baumann angle was 76º in the affected elbow and 73º in the normal elbow. Average time for complete union in the current study was 7 weeks. Pin tract infection was seen in 2, stiffness in 2 patients, cubitus varus in 1 patient. No case of compartment syndrome or iatrogenic nerve injury was seen was recorded.</p><p class="abstract"><strong>Conclusions:</strong> Finally, we concluded that triceps sparing paratricepital approach is an easy, simple and safe approach for exposure and internal fixation of supracondylar humeral fractures in children with excellent functional outcome.</p>

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