scholarly journals Outcomes of Pediatric Supracondylar Fractures of Humerus Treated by Posterior Triceps Splitting Approach

2016 ◽  
Vol 4 (1) ◽  
pp. 28
Author(s):  
Rajeev Dwivedi ◽  
Ruban Raj Joshi ◽  
Subin Byanjankar ◽  
Rahul Shrestha
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Standard Treatment ◽  
Functional Results ◽  
Supracondylar Fracture ◽  
Supracondylar Fractures ◽  
Radiological Criteria ◽  
Supracondylar Humeral Fractures ◽  
The Mean ◽  
Mean Time

Introduction: Close reductions and percutaneous pinning is the gold standard treatment for supracondylar fracture  of humerus. Open reduction and internal fixation is indicated in patients with unacceptable closed reduction, neurovascular compromise, and open fractures. Open reduction can be performed through various approaches. Every approach has their advantages and limitations. The aim of this study was  to assess the functional outcome of pediatric supracondylar fracture of humerus treated by posterior triceps splitting approach.   Methods: This was a prospective evaluation of 20 consecutive patients with displaced pediatric supracondylar humeral fractures operated by triceps spitting posterior approach in our institution for two years. At initial presentation, 19 cases were Gartland III  and one was flexion variant of injury. Complications such as reduction loss, pin migration, infection, osteonecrosis of any part of the elbow, bone healing, and functional results were evaluated. Flynn criteria were used to evaluate the final results.   Results: Twenty patients underwent open reduction and internal fixation by triceps splitting approach. Thirteen patients were male and seven were female with M:F ratio of 1.86:1. The mean age was 6.8 yr (SD=2.74, range 2-14). All the fractures united by six weeks; mean time for union was 4.5 wk (SD=0.94). All patients were assessed at six months using Flynn clinical and radiological criteria. Results were satisfactory in all patients.   Conclusion: Posterior triceps splitting approach is simple, safe and has good functional and radiological outcome. We recommend this approach  for open reduction and internal fixation in pediatric supracondylar fracture.

scholarly journals Functional and radiological outcome after closed reduction and percutaneous pinning versus open reduction and internal fixation in displaced supracondylar fractures in children

2016 ◽  
Vol 19 (2) ◽  
pp. 21-27 ◽  
Author(s):  
Amin Kumar Shrestha ◽  
Suresh Uprety ◽  
Govinda K.C. ◽  
Sharma Paudel
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Supracondylar Fracture ◽  
Age Group ◽  
Radiological Outcome ◽  
Percutaneous Pinning ◽  
Supracondylar Fractures ◽  
Fractures In Children ◽  
Significant Difference ◽  
The Mean

Introduction: Supracondylar fracture of humerus is very common fracture in pediatric age group. The current trends of management in displaced type are close reduction and per cutaneous pinning (CRPP), if reduction is not satisfactory then open reduction and internal fixation (ORIF) is done.  Our study aims to compare the cosmetic, functional and radiological outcome between these two methods. Methodology: Children with displaced extension type supracondylar fracture of distal humerus presenting to emergency room and orthopedics OPD who could meet the inclusion criteria were taken up for study. Sixty-three such patients (37 CRPP and 26 ORIF) were included in the study. Radiological and functional outcomes were followed up at 8 weeks post-operatively. Results: Of the 63 patients enrolled, 26 (41.3%) patients had undergone open reduction and internal fixation and 37 (58/7%) had undergone close reduction and percutaneous pinning. The mean age of patients in CRPP and ORIF groups was 7.29±2.3 years and 8.11±2.02 years respectively. Maximum patients were from age group 7-9 years (46%). Left side was more commonly injured (66.7% vs. 33.3%) (P = 0.045). According to the Flynn’s criteria, cosmetically the outcome did not differ between the two surgical groups (P = 0.23). However, CRPP proved to have a significantly better functional outcome (P=0.000). The mean Bauman’s angle in CRPP and ORIF groups was 16.89±5.66 and 18.88±4.90 degrees respectively. However, there is no statistically significant difference between the type of fixation and Bauman’s angle or Anterior humeral line. Conclusions: Close reduction and percutaneous pinning (CRPP) has better functional and radiological outcome in comparison with open reduction and internal fixation (ORIF) in displaced supracondylar fracture of humerus in children.

FACTORS AFFECTING THE FUNCTIONAL RESULTS OF OPEN REDUCTION AND INTERNAL FIXATION FOR FRACTURE-DISLOCATIONS OF THE PROXIMAL INTERPHALANGEAL JOINT

Hand Surgery ◽  
2015 ◽  
Vol 20 (01) ◽  
pp. 107-114 ◽  
Author(s):  
Kentaro Watanabe ◽  
Yoshitake Kino ◽  
Hiroki Yajima
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Functional Results ◽  
Fracture Dislocation ◽  
Factors Affecting ◽  
Flexion Extension ◽  
Motion Exercise ◽  
Fracture Dislocations ◽  
Pip Joint ◽  
The Mean

To clarify the factors affecting functional results of fracture-dislocations of the proximal interphalangeal (PIP) joint treated by open reduction and internal fixation (ORIF), 60 patients, including 38 patients with a dorsal fracture-dislocation and 22 with a pilon fracture, were analysed. The mean ratio of articular surface involvement was 48.5% and a depressed central fragment existed in 75.3% of the cases. ORIF was performed in 47 patients through a lateral approach using Kirschner wires and in 13 through a palmar approach using a plate or screws. The mean flexion, extension and range of motion (ROM) of the PIP joint was 89.5°, 11.5° and 78.0°, respectively. Stepwise regression analysis revealed that a delayed start of active motion exercise after surgery, elderly age and ulnar ray digit were factors affecting functional outcomes. Although ORIF allows accurate restoration of the articular surfaces, an early start of motion exercise is essential for good results.

scholarly journals “DOUBLE X” FIXATION FOR RARE AND PARTICULAR PEDIATRIC SUPRACONDYLAR HUMERUS FRACTURES

2021 ◽  
Vol 9 (6) ◽  
Author(s):  
Gheorghe Burnei ◽  
Ionuţ Răducan ◽  
Florin-Daniel Enache ◽  
Adriana Dărăban ◽  
Cecilia Avram ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
San Antonio ◽  
Plaster Cast ◽  
Experimental Program ◽  
Supracondylar Fractures ◽  
Supracondylar Humerus Fractures ◽  
Supracondylar Humeral Fractures ◽  
Elbow Pathology

Background Context. The presence of special, rare and various forms which we can encounter when treating supracondylar humeral fractures (SHF) in children, call into question what therapeutic methods can be used to increase the effectiveness of the treatment applied. The aim of this paper is to present the results obtained by using double cross-fixation, "in double X", by closed reduction and percutaneous pinning (CRPP) or open reduction and internal fixation (ORIF) in treating rare and particular forms. Comments and opinions on "double X" method and other cross or side configurations are presented. Patient Sample. All patients with rare and particular forms presented in this article, were operated during 2001-2020 in state and private hospitals. Fixation in "double X" was used either by CRPP and ORIF. The epitrochlear approach (EA) was performed in cases where stability by CRPP could not be ensured or when there were clear signs of ulnar nerve damage. The minimal medial-approach (mMA) highlights the epitrochlea and the fracture of the medial pylon; it has the role of anatomically reducing the medial pylon, thinner and very unstable in rare and particular forms. During 1982-2020 we consulted, treated and evaluated patients with SHF to whom all known treatment methods were applied: orthopedic reduction and immobilization in plaster cast, CRPP, ORIF, minimal-open reduction and internal fixation (mORIF) by mMA and external fixator. Internal fixation was done by the techniques of Judet, San Antonio, San Diego, Dorgan, in “X” and “double X”. In 2001, I introduced "double X" fixation to better stabilize anatomical reductions that showed signs of instability during intraoperative verification. All indications given in the study protocol have been made in accordance with the regulations mentioned in the experimental program. Results. All SHFs operated by CRPP and ORIF by “double X” were cured and satisfactory and good results were obtained in the neglected types operated between 14 and 60 days and good and excellent results were obtained in the rare forms. Conclusions. “Double X” fixation gives the best stabilization and postoperatively there is no need for immobilization in a plaster cast. Recovery may begin the day after surgery. Keywords: supracondylar fractures, child elbow pathology, cross-fixation, lateral fixation, healing and recovery after 30-45 days.

scholarly journals Management of Displaced Supracondylar Fracture of Late Presentation in Children by Open Reduction and Internal Fixation

KYAMC Journal ◽  
2017 ◽  
Vol 7 (2) ◽  
pp. 745-749
Author(s):  
Md Ashraful Islam ◽  
Md Abdur Rashid ◽  
Md Hafizur Rahman Milon ◽  
Mohammed Solayman ◽  
Md Asmaul Hossain Khan
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Late Presentation ◽  
Supracondylar Fracture ◽  
Control Group ◽  
Joint Motion ◽  
Supracondylar Fractures ◽  
Kirschner Wires ◽  
Average Delay ◽  
Multicentric Study

Background: In late presentation of cases there is dilemma whether to wait for osteotomy later or do open reduction on arrival. The purpose of this prospective multicentric study is to evaluate the functional outcome of open reduction and internal fixation (ORIF) with crossed Kirschner wires fixation and early joint motion in the late presentation of supracondylar fractures in children.Methods: A total of 21 children, with an average delay of 22.5 days, with displaced type III Gartland supracondylar fracture, were treated by ORIF with crossed Kirschner wires fixation and early joint motion. Average follow-up was 12 months.Results: Flynn's criteria were used to evaluate the outcome. All of them had more functional range of motion of the injured elbow than the published reports.Conclusions: Most of the surgeons in the developing world prefer ORIF for optimal results. Thus it appears to be justifiable to go for ORIF with K-wires even in the late presentation of supracondylar fractures. The overall results are encouraging. However, the small number of cases and lack of control group are the limitations of this study. The study is ongoing and so the full report with more cases will be presented later.KYAMC Journal Vol. 7, No.-2, Jan 2017, Page 745-749

scholarly journals Open Reduction and Internal Fixation of Displaced Supracondylar Fracture of Late Presentation in Children: A Preliminary Report

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Ram K. Shah ◽  
Raju Rijal ◽  
Rosan P. Shah Kalawar ◽  
Sujit R. Shrestha ◽  
Niraj Kumar Shah
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Late Presentation ◽  
Supracondylar Fracture ◽  
Control Group ◽  
Joint Motion ◽  
Supracondylar Fractures ◽  
Kirschner Wires ◽  
Multicentric Study ◽  
Fractures In Children

Background. In late presentation of cases there is dilemma whether to wait for osteotomy later or do open reduction on arrival. The purpose of this prospective multicentric study is to evaluate the functional outcome of open reduction and internal fixation (ORIF) with crossed Kirschner wires fixation and early joint motion in the late presentation of supracondylar fractures in children. Methods. A total of 21 children, with an average delay of 20.3 days, with displaced type III Gartland supracondylar fracture, were treated by ORIF with crossed Kirschner wires fixation and early joint motion. Average follow-up was 12 months. Results. Flynn’s criteria were used to evaluate the outcome. All of them had more functional range of motion of the injured elbow than the published reports. Conclusions. Most of the surgeons in the developing world prefer ORIF for optimal results. Thus it appears to be justifiable to go for ORIF with K-wires even in the late presentation of supracondylar fractures. The overall results are encouraging. However, the small number of cases and lack of control group are the limitations of this study. The study is ongoing and so the full report with more cases will be presented later.

Compare the Functional Outcomes of Closed Reduction and Percutaneous Cross Pinning versus Lateral Pinning in Supracondylar Fracture of Humerus in Children

2021 ◽  
Vol 15 (8) ◽  
pp. 2154-2156
Author(s):  
Abid Ali Khan ◽  
Mohammad Younas ◽  
Assad Mehmood ◽  
Bissma Laraib
Keyword(s):  
Traffic Accidents ◽  
Functional Results ◽  
Supracondylar Fracture ◽  
Supracondylar Fractures ◽  
Group I ◽  
Supracondylar Humerus Fractures ◽  
Group Ii ◽  
Mean Time ◽  
Methods Of Treatment ◽  
Radiation Time

Objective: To determine results of treating supracondylar fracture of the humerus in children using percutaneous cross pinning versus two lateral pinning. Study Design: Prospective study Place and Duration of Study: Department of Orthopaedics, King Abdullah Teaching Hospital Mansehra from 1st November 2020 to 30th April 2021 Methodology: Eighty four patients of both genders were enrolled. Baseline demographic details of patient’s age, sex and body mass index were recorded after taking consent. Patients aged between 2-14years were included. Children with supracondylar humerus fractures were enrolled and divided equally into 2-groups. Group I had 42 patients and received percutaneous cross pinning technique and group II had 42 patients underwent lateral pinning. Radiological and functional results were assessed by Flynn’s criteria among both groups and frequency of complications was also observed. Results: There were 50 (59.5%) males (25 in each group) and 34 (40.5%) were females (17 in each group. Mean age of the patients in group I was 5.14±9.88 years and in group II mean age was 6.14±8.35 years. Sports 60 (71.43%) was the most common cause of fracture followed by traffic accidents 17 (20.24%) and the rest were 7 (8.3%) fall from the height. Mean surgical time in group I was 30.42±6.09 minutes while in group II mean time was 34.24±2.16 minutes. Mean radiation time in group I was 3.98±9.44 sec and in group II radiation time was 2.11±1.1sec. According Flynn’s criteria excellent results in group I were found in 25 (59.5%) cases, good results in 12 (28.6%) and fair results found in 5 (11.9%) while in group II excellent results were found in23 (54.8%), good results in 15 (35.7%) and fair results in 4 (9.5%). Significantly no difference in outcomes was observed among both groups. Conclusion: Both methods of treatment of supracondylar fractures of humerus are safe and successful however less operative and high time of radiation in cross percutaneous pinning compared to two lateral pinning has been found. Keywords: Percutaneous cross pinning, Two lateral pinning, Supracondylar humerus fracture

scholarly journals Supracondylar fracture, buried vs non buried K wires.

2020 ◽  
Vol 27 (03) ◽  
pp. 467-471
Author(s):  
Usama Bin Saeed ◽  
Muhammad Waseem ◽  
Allah Rakha Hassan ◽  
Zeeshan Ali Khan ◽  
Dilshad Gill ◽  
...  
Keyword(s):  
Tract Infection ◽  
Internal Fixation ◽  
Open Reduction ◽  
Supracondylar Fracture ◽  
Supracondylar Fractures ◽  
Elbow Fractures ◽  
Group A ◽  
K Wires ◽  
Pin Tract Infection ◽  
Group B

Supracondylar fracture of the humerus is the second most common fracture in children (16.6%), and is most common fracture around the elbow in children comprise (60%) to (75%) of all elbow fractures. There is very little data available about the burier of wires under the skin reduces the pin tract infection rate as low as 2.27%.2 Objectives: To compare the frequency of pin tract infection between nonburied and buried K-wires after open reduction internal fixation in supracondylar fracture of humerus in children. Study Design: Prospective Cohort Study. Setting: Department of Orthopedics Surgery & Traumatology Allied Hospital Faisalabad. Period: From June 2014 - June 2017. Material & Methods: Patients were selected according to the inclusion criteria. All patients were registered in ER with a history of trauma and having the diagnosis of Supracondylar fracture. Two groups were made; Group A (Buried), Group B (Non-buried). They were followed for the signs of infection. Results:  Out of 80 cases 45 (56.3 %) were male and 35 (43.8 %) female. In group A (non-buried) there were 40 patients and Mean age was 7.57± 2.07 years, pin tract were infected in 8 (20%) patients and there were no pin tract infection in 32 (80%) patients. And in group B (buried) there were 40 patients and mean age was 7.38± 2.17 years, Pin tract was infected in 1(2.5%) patient and there were no pin tract infection in 39(97.5%). Conclusion: Our study showed that rate of infection is significantly reduced in burying of K-wires after open reduction and internal fixation of supracondylar fractures as compared to non-burying technique.

scholarly journals FUNCTIONAL OUTCOME OF PROXIMAL HUMERUS FRACTURES TREATED WITH OPEN REDUCTION AND INTERNAL FIXATION WITH A LOCKING COMPRESSION PLATE: A CROSS SECTIONAL STUDY

2021 ◽  
Vol 10 (4) ◽  
pp. 3266-3269
Author(s):  
Abhishek Patil
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Open Reduction ◽  
Proximal Humerus ◽  
Constant Score ◽  
Locking Compression Plate ◽  
Proximal Humerus Fractures ◽  
Compression Plate ◽  
Humerus Fractures ◽  
The Mean

Proximal humerus fractures account for about 4% to 5% of all fractures. Following distal forearm fracture, proximal humeral fracture is the second most common upper extremity fracture. Kirschner (K)-Wires, external fixation, tension band wiring, and rush pins, intramedullary nails, ORIF with plates, and shoulder hemiarthroplasty have all been offered as therapeutic options. The purpose of this study was to assess the functional outcome and complication rates following internal fixation of proximal humerus fractures using a locking compression plate. Patients over the age of 18 with closed proximal humerus fractures or open proximal humerus fractures (Gustilo and Anderson type I, Type II) received open reduction and internal fixation with locking compression plate in the current study. The participants in this study were 60 people who had a proximal humerus fracture and were treated with open reduction and a proximal humerus locking compression plate. Patients ranged in age from 20 to 85 years old, with a mean age of 51.14 +/- 17.30 years. The age group 36–55 years (37 percent) was the most prevalent, followed by 56–75 years (30 %). The majority of patients (76.7 %) were men who had been in automobile accidents on the right side (83 %) (63 %). According to the Neer classification, the most prevalent type of fracture was a three-part fracture (53 %). The maximum union time observed in this study was 16 weeks, with a minimum of 10 weeks. The average time to union is 12.52 +/- 1.14 weeks. The mean flexion at the end of six months was 121.660 +/- 19.84. The mean internal rotation was 57.330 +/- 8.48, the mean external rotation was 530 +/- 11.98, and the mean abduction was 1180 +/- 19.36. 75.28 +/- 9.66 [Mean +/- SD] is the Mean Constant score. Pain 14.10, ADL 18.26, range of motion 22.46, and power 20 were the mean scores observed on Constant Score for its various aspects. According to the Constant score, the functional outcome of the 60 patients was as follows: 8 patients had excellent outcomes (13%), 34 patients had good outcomes (56.7%), 16 patients had moderate outcomes (26.7%), and two patients had poor outcomes (26.7%) and (3 %). Internal fixation of proximal humerus fractures with a locking compression plate results in anatomical reduction and secure fixation, resulting in a favorable functional outcome.

scholarly journals Functional results after operative treatment of talus fractures

2021 ◽  
Vol 13 (1) ◽  
pp. 1-6
Author(s):  
Andreja Gavrilovski ◽  
Aleksandra Gavrilovska-Dimovska ◽  
Goran Aleksovski
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Functional Results ◽  
High Rate ◽  
Posttraumatic Osteoarthritis ◽  
Anatomic Reduction ◽  
Aseptic Osteonecrosis ◽  
The University ◽  
With Screws

Fractures of the talus do not occur frequently, accounting for about 0.1% of all fractures. Failure to achieve anatomic reduction, exponentially increases the risk of postoperative aseptic osteonecrosis and posttraumatic osteoarthritis. The purpose of this study was to evaluate and compare the short-term and medium-term functional outcomes in patients who underwent open reduction and internal fixation of talus fractures. Materials and methods: At the University Clinic for Traumatology in the period between 2017 to 2020, 14 patients with talus fractures were surgically treated. The inclusion and exclusion factors were determined, all patients signed the consent and the study passed the ethics committee. Results: All patients underwent open reduction and internal fixation with screws or reconstructive plate. Follow-up was done on the 14th postoperative day, 1st month, 3rd month and 6th month. At the 6th month follow-up, the functional outcome was tested using the Kitaoka score unified by the American Orthopedic Foot and Ankle Society. This injury is too rare for conclusions to be brought out of and to be compared to larger studies. However, all major studies from reference trauma centers lead to the same conclusions, that the treatment of these fractures is complex Anatomical reduction is mandatory for a better outcome. Conclusion: A protocol for the treatment of posttraumatic osteoarthritis should be introduced, given the high rate of its occurrence despite the satisfactory surgical technique.

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