scholarly journals DISPLACED SUPRACONDYLAR HUMERAL FRACTURES;

2013 ◽  
Vol 20 (05) ◽  
pp. 818-824
Author(s):  
ZAKIR ALI SHAH, ◽  
UZMA ARIF
Keyword(s):  
Range Of Motion ◽  
Controlled Trial ◽  
Supracondylar Fractures ◽  
Lateral Entry ◽  
Loss Of Reduction ◽  
Wire Fixation ◽  
Supracondylar Humeral Fractures ◽  
Group A ◽  
K Wires ◽  
Group B

Objective: To compare outcome of patients with supracondylar fractures of humerus treated by cross k wires and lateralentry k wires in children. Study Design: Randomized controlled trial study. Place and duration of study: January 2012 to December2012 at Department of Orthopedics, Nawaz Sharif Social Security hospital, Lahore. Subjects and Methods: Two hundred patients,meeting the selection criteria were identified. These patients were divided into group A and group B randomly. In group A cross k wirefixation and in group B lateral entry k wire fixation was performed. Loss of reduction was assessed and recorded in the immediatepostoperative period and three weeks later at the time of removal of k wires. Range of motion of the elbow, in the form of excellent outcomewas assessed at the end of 12 weeks postoperatively. Results: A total of 200 patients were included in the study. Loss of reduction wasfound in thirty patients (30%) in group A and in forty one patients (41%) in group B. In group A, seventy two patients (72%) had excellentoutcome while twenty eight patients (28%) did not gain the desired range of motion at elbow. In group B, sixty five patients (65%) hadexcellent outcome while in thirty five patients (35%), the desired range of motion at elbow was not achieved. No neurological injuryoccurred with both configurations. Conclusions: Lateral entry k wire fixation is as effective as cross k wire in the treatment of displacedsupracondyler fracture of humerus in children.

scholarly journals Comparison of Outcome of Lateral K-Wire Fixation Verses Medio-Lateral Crossed K-Wire Fixation for Displaced Extension Type of Supracondylar Humeral Fractures in Children

2014 ◽  
Vol 2 (3) ◽  
pp. 20-25 ◽  
Author(s):  
HK Gupta ◽  
D Chaurasia
Keyword(s):  
Closed Reduction ◽  
P Value ◽  
Supracondylar Fractures ◽  
Lateral Entry ◽  
Pin Fixation ◽  
Wire Fixation ◽  
Supracondylar Humeral Fractures ◽  
Group A ◽  
Ulnar Nerve Injury ◽  
Group B

INTRODUCTION: Supracondylar humeral fractures are the most common elbow fractures seen in children. The purpose of this study was to compare the efficacy of lateral entry pin fixation with that of medial and lateral entry pin fixation for the operative treatment of displaced extension supracondylar fractures of the humerus in children. MATERIAL AND METHODS: Total of 50 cases of displaced supracondylar fracture humerus were enrolled in study, 25 cases in two equal groups, Group A and group B. Group A received treatment by closed reduction with lateral k-wire fixation and Group B received treatment by closed reduction and medio-lateral k-wire fixation. The cases were followed at 4 weeks when slab was removed and physiotherapy started, and at 12 weeks for final outcome. The outcome was measured as per Flynn's criteria.RESULTS: The mean age of patents in group A was 6.40 years and in group B was 6.44 years. At final follow up, in group A, 18 (72%) cases had excellent, 7 (28%) good result, in group B; 20 (80%) had excellent, and 5 (20%) had good result. The p- value (0.08) derived between them was statistically not significant. Three pateints got superficial pin tract infection in group A and two iatrogenic ulnar nerve injury and one pin had pintract infection in group B. There were also no significant differences (p value- 0.697) between groups with respect to the baumann angle. CONCLUSION: Both lateral entry pin fixation and medio- lateral entry pin fixation are effective in the treatment of completely displaced (type-III) extension supracondylar fractures of the humerus in children. Although there remains subtle risk of ulnar nerve injury in medio-lateral pin fixation.DOI: http://dx.doi.org/10.3126/jucms.v2i3.11823 Journal of Universal College of Medical Sciences Vol.2(3) 2014: 20-25

scholarly journals Radiation Exposure in The Treatment of Pediatric Supracondylar Humerus Fractures: Comparison of Two Fixation Methods

2021 ◽  
Vol 15 (1) ◽  
pp. 22-26
Author(s):  
Themistoklis Tzatzairis ◽  
Gregory Firth ◽  
Paulien Bijlsma ◽  
Dimitrios Manoukian ◽  
Claudia Maizen ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Radiation Exposure ◽  
Trauma Centre ◽  
Fixation Method ◽  
Supracondylar Fractures ◽  
Lateral Entry ◽  
Major Trauma Centre ◽  
Supracondylar Humerus Fractures ◽  
Wire Fixation ◽  
K Wires

Aim: The study aims to determine the estimated radiation exposure of two different types of fixation (crossed vs lateral-entry K-wires) for displaced supracondylar fractures at a Major Trauma Centre in London. Methods: A retrospective review was performed between 2015 and 2019 in children (<16 years old) who underwent either Closed Reduction and Percutaneous Pinning (CRPP) or open reduction and K wire fixation for a displaced supracondylar fracture (Gartland II, III and IV) of the humerus. Results: The overall mean radiation dose and duration with crossed K-wire fixation was statistically lower when compared with two lateral K-wires. The mean radiation dose increased with increasing Gartland Grade - for Gartland Grades II, III and IV respectively. Conclusion: The current study showed statistically significant decreased radiation dose in crossed K-wire fixation method, compared to lateral-entry fixation. No difference was found regarding the cosmetic/functional outcome when Flynn’s criteria were applied.

scholarly journals Percutaneous transolecranon pinning and lateral pinning Vs lateral pinning in displaced supracondylar fractures of humerus in children: an observative study

2019 ◽  
Vol 7 (3) ◽  
pp. 717
Author(s):  
Ramesh Chand Jindal ◽  
Manjeet Singh ◽  
H. S. Sandhu ◽  
Gurwinder Singh Bal ◽  
Harish V. K. Ratna ◽  
...  
Keyword(s):  
Supracondylar Fracture ◽  
Supracondylar Fractures ◽  
Articular Fracture ◽  
Lateral Entry ◽  
Group A ◽  
K Wires ◽  
Fracture Humerus ◽  
Immature Skeleton ◽  
Vertical Wire ◽  
Flexion And Extension

Background: Supracondylar fracture (humerus) is type of extra-articular fracture occurring in the distal metaphyseal site of humerus. It is almost exclusively a fracture of the immature skeleton, seen in children and young teenagers. Fractures around the elbow are a great challenge to orthopaedic surgeons. Clinical diagnosis may be difficult due to noncooperative patient and massive swelling around the elbow. Displaced type of supracondylar fractures poses problem not only in reduction but also in maintenance of reduced fracture   and   rapid   inclusion   of nerves and vessels.Methods: The present study was conducted on 30 cases of displaced supracondylar fracture humerus in children, aged 2-14 years, who were treated by CRPP with either lateral entry of k-wires or a lateral wire and a vertical wire through olecranon (transolecranon).Results: Both the Groups achieved 90% satisfactory results, but 10% unsatisfactory results recorded in Group A only rather than in Group B.Conclusions: Although the transolecranon wire has the disadvantage of limiting the flexion and extension of the elbow, this does not influence the final-outcome much as the elbow is fixed in a POP splint for minimum 3 weeks-in all patients in both groups.

scholarly journals Comparison of closed reduction and percutaneous cross verses parallel k wire fixation in supracondylar fractures of the humerus in children.

2020 ◽  
Vol 27 (03) ◽  
pp. 476-480
Author(s):  
Farhan Majeed ◽  
Mudasser Saddique ◽  
Hafiz Nasir ◽  
Ahmad Shams
Keyword(s):  
Nerve Injury ◽  
Ulnar Nerve ◽  
Closed Reduction ◽  
Functional Results ◽  
Supracondylar Fractures ◽  
Fractures In Children ◽  
Wire Fixation ◽  
Group A ◽  
Ulnar Nerve Injury ◽  
K Wires

Around the elbow, supracondylar injury of humerus is one of the conventional fractures which usually occurs at the age of 7 to 8 years. Various conservative techniques have been used for the management, which comprises of the splintage, tractions, open or closed reduction with k wire fixation. However, closed reduction and percutaneous pinning remains the mainstay of surgical management, for they have shown splendid outcomes according to many authors. Objectives: The aim of this study is to summarise and compare the radiological and functional results of two ways of fixation (cross and parallel closed K wires) of supracondylar fractures in children. Study Design: Randomized controlled trial. Setting: Department of Orthopaedics Surgery, Services Hospital, Lahore. Period: 1st January 2018 to 31st June 2018. Material & Methods: We included 180 patients (90 in each group). Results: The mean age was 6.45±2.34 years with 115(63.9%) male and 65(36.1%) female. Among the children who underwent fixation with cross k-wires, ulnar nerve injury was seen in 2(2.2%) cases and none were seen in the other group post operatively. Group A attained higher union rate at last follow up. 4(4.4%) cases in Cross K-wires and 19(21.1%) in two lateral k-wires gave outstanding outcome. In a nutshell, 60 in group A and 45 in group B showed excellent outcomes based on Flynn's criteria, p-value < 0.05. Conclusion: According to Flynn’s criteria, closed percutaneous cross K-wire fixation of supracondylar fracture of humerus is an effective management option in terms of finer functional results as compared to Parallel k-wires. Although, the rate of radiological union is higher in cross k-wire fixation, there are 2.2% chances of ulnar nerve injury.

scholarly journals Tips and pitfalls of reduction and fixation in displaced supracondylar fractures in children

2021 ◽  
Vol 0 ◽  
pp. 1-7
Author(s):  
Joon-Woo Kim ◽  
Kyeong-Hyeon Park ◽  
Chang-Wug Oh
Keyword(s):  
Closed Reduction ◽  
Humeral Fractures ◽  
Cubitus Varus ◽  
Supracondylar Fractures ◽  
Fixation Technique ◽  
Lateral Entry ◽  
Reduction Techniques ◽  
Fractures In Children ◽  
Loss Of Reduction ◽  
Supracondylar Humeral Fractures

Supracondylar humeral fractures are the most common injury of the elbow in children. Compared to flexion type fractures, extension type fractures are more common, up to 98%. Gartland classification has been used to guide the management of this injury, which is based on the extent of the displacement. If not adequately managed, completely displaced (type III) fractures may have a higher incidence of concomitant injury or complications, including neurovascular injury, compartment syndrome, or cubitus varus. Closed reduction followed by percutaneous pinning has been suggested as the standard operative method for the displaced supracondylar humeral fractures. However, these fractures can be challenging to reduce, with the traditional technique of closed reduction. Lateral-entry pinning is known as a sufficient method of fixation for this injury. However, the lateral pin only fixation technique may also result in loss of reduction in some particular patterns of fractures, such as fractures with medial column comminution. We discuss and describe the reduction techniques of completely displaced supracondylar humeral fractures, including technical tips and pitfalls for closed reduction and open reduction. We also discuss indications of medial pinning, and its safe method, when the lateral-entry pins may not achieve adequate stability.

scholarly journals Effect of Cyriax Deep Friction Massage Versus Cryotherapy in Stage 1 & 2 of Adhesive Capsulitis: A Randomized Controlled Trial

2021 ◽  
pp. 40-48
Author(s):  
Saumya Srivastava ◽  
K. Sukanya ◽  
Harramb Mittal
Keyword(s):  
Randomized Controlled Trial ◽  
Physical Therapy ◽  
Range Of Motion ◽  
Controlled Trial ◽  
Adhesive Capsulitis ◽  
Statistical Significance ◽  
Randomized Controlled ◽  
Group A ◽  
Group B ◽  
Stage 1

Background: Adhesive capsulitis is one of the common pathologies of the Shoulder. The prevalence of adhesive capsulitis is estimated to be 2% to 5% of the general population. Several treatment techniques are existing for the improvement of adhesive capsulitis and Cyriax deep friction massage is a technique designed to improve adhesive capsulitis. Objective: To compare between the effects of Cyriax deep friction massage and conventional physical therapy with Cryotherapy and conventional physical therapy in stage 1 &2 of adhesive capsulitis. Methods/ Design: The study is a randomized controlled trial which included 34 subjects of the age group 40-85 years and were randomly assigned into two groups: group A (n=17) and group B (n=17). The Group A was given Cyriax deep friction massage with conventional physical therapy while group B was given Cryotherapy therapy with conventional physical therapy. Outcome measure were taken at baseline, and then taken on last day of sixth session by using Visual Analogue Scale (VAS), Range of Motion (ROM), and Shoulder Pain and Disability Index (SPADI). The treatment was given for 6 sessions over a period of two weeks. Results: Group A showed greater improvement after 2 weeks of intervention with a statistical significance value for SPADI, VAS and ROM. Conclusion: Cyriax deep friction massage with conventional physical therapy has significant effect on pain, range of motion and functional activity in patients with adhesive capsulitis. Trial registration: prospectively registered in the clinical trial registry-India in the registration number of CTRI/2019/09/021375.

scholarly journals Medio-lateral entry pin versus lateral entry pin for displaced pediatric supracondylar fractures: A comparative, prospective study

2016 ◽  
Vol 11 (4) ◽  
pp. 28-31
Author(s):  
Manoj Kandel ◽  
Hemant Kumar Gupta ◽  
Rajkumar Ravi Hamal ◽  
Amit Ranjan Mishra ◽  
Rahul Shrestha ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Ulnar Nerve ◽  
Supracondylar Fractures ◽  
Lateral Entry ◽  
Fractures In Children ◽  
Lateral Group ◽  
Significant Difference ◽  
The Mean ◽  
Carrying Angle ◽  
Group B

Background & Objectives: Supracondylar fracture is one of the commonest fractures in children. Although the technique of pinning is controversial, percutaneous medio-lateral entry pinning is theoretically considered more stable biomechanical construct. The drawback of this method is injury to ulnar nerve which is not encountered in only lateral entry pinning.Materials & Methods: This was a prospective, comparative and observational study done in 60 patients which was alternately divided into two groups. The first group (A) underwent medio-lateral entry pinning and the second group (B) underwent lateral entry pinning. They were followed for 24 weeks and the outcome was assessed using Flynn’s criteria.Results: At twenty-four weeks, the mean loss of range of motion of elbow in medio-lateral pinning group was 3.70 degrees (SD±1.93) and that in lateral pinning group was 4.23 degrees (SD ±1.38). The mean loss in carrying angle at twenty-four weeks in medio-lateral group was 2.93 degrees (SD±2.19) and that in lateral group was 4.17 (SD±2.24). There were 2 (6.67%) cases of iatrogenic ulnar nerve injury in medio-lateral pinning group. Out of thirty patients, in medio-lateral pinning group, 25 had excellent results, 5 had good results and none had fair or poor results. While out of 30 patients in lateral pinning group, 23 had excellent results, 7 had good results and none had fair or poor results.Conclusion: There is no significant difference in outcome in terms of loss of carrying angle and range of motion between the medio-lateral pinning group and the lateral pinning group at the end of 6 months.Journal of College of Medical Sciences-Nepal, Vol.11(4) 2015: 28-31

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 A clinical study of closed reduction and percutaneous Kirschner wire fixation of displaced supracondylar fractures of humerus in children

2017 ◽  
Vol 3 (2) ◽  
pp. 282
Author(s):  
Mohammad Asimuddin ◽  
Raju H. Kulkarni
Keyword(s):  
Closed Reduction ◽  
Kirschner Wire ◽  
Fracture Pattern ◽  
Supracondylar Fractures ◽  
Female Ratio ◽  
Lateral Entry ◽  
Kirschner Wire Fixation ◽  
Supracondylar Humerus Fractures ◽  
Wire Fixation ◽  
K Wires

<p class="abstract"><strong>Background:</strong> Supracondylar fractures of the humerus are the most common fracture pattern of the elbow in children. Displaced supracondylar fractures are notorious for difficulty in reduction, maintenance of reduction and frequent involvement of neurovascular structures. The purpose of this study was to evaluate the results of stabilization of these fractures by closed reduction and percutaneous Kirschner wire fixation.</p><p class="abstract"><strong>Methods:</strong> Thirty cases of displaced supracondylar humerus fractures were included in the study. The mean age of the patient was 8.3 years [ranges from 4-14 years]. The male to female ratio was 2:1 and left side was involved in 23 cases whereas 7 had right sided injuries. All fractures were of extension type [Gartland’s type III]. Posteromedial displacement was noted in 22 cases whereas 8 fractures were posterolaterally displaced. In 20 cases, lateral entry wires alone were used whereas in 10 cases one lateral and one medial K-wire were used. K- wires were removed after 3 weeks post-operatively and follow-up was done at 6 weeks,12 weeks, 6 months and 12 months, when they  were evaluated according to Flynn’s criteria.<strong></strong></p><p class="abstract"><strong>Results:</strong> Results were graded using Flynn’s criteria. Excellent results were achieved in 18 [60%], good in 6 [20%] fair in 4 [13.3%], while poor results were seen in 2 [6.7%] patients.</p><p><strong>Conclusions:</strong> Closed reduction and percutaneous fixation using Kirschner wires is a safe and efficient method for fixation of displaced supracondylar fractures of the humerus in children. </p>

Radiological and Functional Outcome of Distal Radius Fracture treated conservatively vs Percutaneous K-wire fixation

2021 ◽  
Vol 15 (8) ◽  
pp. 1842-1845
Author(s):  
Ali Raza ◽  
Hafiz Muhammad Kashif Saleem ◽  
Mariam Chaudhry ◽  
Muhammad Usman Khalid
Keyword(s):  
Conservative Treatment ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Radius Fracture ◽  
Union Rate ◽  
Manipulation Under Anesthesia ◽  
Wire Fixation ◽  
Group A ◽  
K Wires ◽  
Group B

Aim: To compare the radiological and functional result of conservatively treated distant radius fractures (manipulation under anesthesia and plaster of paris) versus percutaneous K- wire fixation Study design: Retrospective Duration and place of study: Department of Orthopedic Surgery, The Indus Hospital, Raiwind campus Lahore from July 2018 to August 2020. Methods: The sample size of 100 patients aged between 18-60 years, closed, isolated distal radius fracture were included, and patients with diabetes mellitus, ischemic heart disease, pathological fractures, chronic renal disease, head injury, chronic liver disease, whose Glasgow coma scale was <14, malignancy were excluded. Patients were randomized as A & B by lottery method. They managed with conservative treatment ( manipulation under anesthesia (MUA) and plaster of paris (POP) cast) and K- wire fixation in groups A & B, respectively. Side of the fractured bone, infection, radiological union, and function outcome were recorded. Results: Amongst the total 100 patients in group-A, 32(63.8%) were males, and 18(36.2%) were females, and 35 (70.2%) were males, and 15 (29.8%) were females in Group-B. in group A patients mean age was 38.86.19 years, while patients mean age of the group B was 39.57.36 years. With the conservative method, 45(95.7%), the union rate was while with the K- wire fixation method, the union rate was 48(96%). In group-A, 35(70%) had excellent, 10 (20%) good, 03 (6%) had an average, and 2(4%) poor and in group-B, 40(80%) had excellent, 04 (08%) good, 04(08%) had an average, and 02 (4%) poor functional outcome. Conclusion: In terms of clinical and radiological evaluation, fixation of a distal radius fracture with K-wires has a better outcome than conservative treatment (MUA and POP cast) with a low infection rate and better union and result. Keywords: closed fracture, distal radius, back slab, K-wires

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