scholarly journals Three lateral divergent pinning for displaced supracondylar humerus fractures in children

2015 ◽  
Vol 1 (2) ◽  
pp. 30-34
Author(s):  
Rojan Tamrakar ◽  
Ramod Khanal ◽  
Balakrishnan M. Acharya ◽  
Nabees Man Singh Pradhan ◽  
Suman Kumar Shrestha
Keyword(s):  
Closed Reduction ◽  
Image Intensifier ◽  
Supracondylar Fractures ◽  
Stable Fixation ◽  
Fractures In Children ◽  
Loss Of Reduction ◽  
Supracondylar Humerus Fractures ◽  
Supracondylar Humeral Fractures ◽  
Humerus Fractures ◽  
Ulnar Nerve Injury

Introductions: Cross or two lateral pinnings are the most commonly done procedures for displaced supracondylar humerus fractures in children. A crossed pin is biomechanically stable than lateral pins, but associated with risk of iatrogenic ulnar nerve injury. Recent studies have shown stable fixation with three lateral pin construct. The purpose of this study was to evaluate the efficacy of three lateral divergent pinning for displaced supracondylar humerus fractures.Methods: Thirty five children with Gartland types III were treated between November 2012 and November 2013. Closed reduction and three lateral divergent pinning was done with image intensifier guidance. Patients were followed up for minimum 6 months. Radiological assessment was done to see union, proper pin placement and loss of reduction. Clinically, patients were assessed by using Flynn criteria.Results: There were 24 (68.6%) male and 11 (31.4%) female children between 2 to 13 years of age with displaced supracondylar fractures, left side 26 (74.3%) and right nine (25.7%) cases. All were successfully managed with closed reduction and three lateral divergent pins within 2-6 days of injury. One radial and one median nerve palsies sustained at injury recovered spontaneously. No iatrogenic nerve injuries occurred. A comparison of perioperative and final radiographs revealed no loss of reduction. Twenty-seven excellent, five good, two fair and one poor results on Flynn’s grading. One patient had a superficial pin-tract infection.Conclusions: Closed reduction with three lateral divergent pins is safe for stable fixation of displaced supracondylar humeral fractures in children.

scholarly journals Displaced supracondylar humeral fractures in children: Comparison of three treatment approaches

2016 ◽  
Vol 144 (1-2) ◽  
pp. 46-51 ◽  
Author(s):  
Sinisa Ducic ◽  
Marko Bumbasirevic ◽  
Vladimir Radlovic ◽  
Petar Nikic ◽  
Zoran Bukumiric ◽  
...  
Keyword(s):  
Closed Reduction ◽  
Open Reduction ◽  
Type Ii ◽  
Percutaneous Pinning ◽  
Cast Immobilisation ◽  
Fractures In Children ◽  
Supracondylar Humerus Fractures ◽  
Wire Fixation ◽  
Supracondylar Humeral Fractures ◽  
Humerus Fractures

Introduction. Closed reduction and percutaneous pinning are the most widely used treatment options for displaced supracondylar humerus fractures in children, but there is still no consensus concerning the most preferred technique in injuries of the extension type. Objective. The aim of this study was to compare three common orthopaedic procedures in the treatment of displaced extension type supracondylar humerus fractures in children. Methods. Total of 93 consecutive patients (66 boys and 27 girls) referred to our hospital with Gartland type II or III extension supracondylar humeral fractures were prospectively included in the study over a six-year period. At initial presentation 48 patients were classified as Gartland type II and 45 as Gartland type III fractures. The patients were subdivided into three groups based on the following treatment modality: closed reduction with percutaneous pinning, open reduction with Kirschner wires (K-wires) fixation, and closed reduction with cast immobilisation. The treatment outcome and clinical characteristics were compared among groups, as well as evaluated using Flynn?s criteria. Results. Excellent clinical outcome was reported in 70.3% of patients treated with closed reduction with percutaneous pinning and in 64.7% of patients treated with open reduction with K-wire fixation. The outcome was significantly worse in children treated with closed reduction and cast immobilisation alone, as excellent outcome is achieved in just 36.4% of cases (p=0.011). Conclusion. Closed reduction with percutaneous pinning is the method of choice in the treatment of displaced pediatric supracondylar humeral fracture, while open reduction with K-wire fixation is as a good alternative in cases with clear indications.

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

2014 ◽  
Vol 2 (1) ◽  
pp. 29-33
Author(s):  
Lazar Todorovic ◽  
Mile Petrovski ◽  
Aco Dimov ◽  
Riste Simeonov ◽  
Marjan Kamiloski ◽  
...  
Keyword(s):  
Supracondylar Fractures ◽  
Cubitus Valgus ◽  
Fractures In Children ◽  
Number Of Patients ◽  
Single Centre Experience ◽  
Supracondylar Humerus Fractures ◽  
Supracondylar Humeral Fractures ◽  
Humerus Fractures

Aim: The aim of this study is to show our experience in cases of dislocated extension type – supracondylar humeral fractures and evaluate the results of their treatment in the period from 2000 to 2010 with a follow up of a maximum six months.Material and Methods: A retrospective analysis of the clinical cases for the period 2000 – 2010 was done. Children from 4 to 14 years of age with supracondylar fractures of the humerus – extension type are included. The total number of patients treated at the Clinic for Pediatric Surgery was 230.Results: The results of the treatment were evaluated after the last control examination six months later. We noticed postoperative neurological damage in 10 cases (4.85%). In 14 patients (6.8%) we noticed long term deformities such as cubitus varus or cubitus valgus. Infection at the entering place of the needles occurred in 4 patients (1.94%), which did not indicate premature extraction of the needles and conversion of the treatment.Conclusion: As a conclusion, we can stress that our outcomes in treatment of dislocated suparacondylar fractures of the humerus in children meet the world standards.

Comparison of Outcome of Three Different Approaches for Supracondylar Humerus Fractures in Children

2021 ◽  
Vol 15 (10) ◽  
pp. 3482-3484
Author(s):  
Syed Usman Shah ◽  
Mohammad Younas ◽  
Naseer Ullah Khattak ◽  
Amina Gul Shehzar Khan ◽  
Sultan Shah ◽  
...  
Keyword(s):  
Posterior Approach ◽  
Lateral Approach ◽  
Supracondylar Fractures ◽  
Medial Approach ◽  
Fractures In Children ◽  
Supracondylar Humerus Fractures ◽  
Significant Difference ◽  
Group A ◽  
Humerus Fractures ◽  
Group B

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

scholarly journals Therapeutically effect of the physical procedures on the elbow contractures in children with supracondylar humerus fractures

2007 ◽  
Vol 54 (2) ◽  
pp. 39-43 ◽  
Author(s):  
S.Dj. Jandric
Keyword(s):  
Physical Therapy ◽  
Range Of Motion ◽  
Elbow Joint ◽  
Pediatric Population ◽  
Excellent Result ◽  
Supracondylar Fractures ◽  
Functional Disturbance ◽  
Fractures In Children ◽  
Supracondylar Humerus Fractures ◽  
Humerus Fractures

Supracondylar humerus fractures are the most common fracture around the elbow in the pediatric population. These fractures in children may lead to functional disturbance with loss or reduction of range of motion in the elbow joint. The aim of this study was to investigate the effect of the physical therapy on the range of the motion of the elbow joint in the post-traumatic elbow contractures in the childhood after supracondylar fractures. We analyzed in this research 34 children (average age 8.57+2.94 years) with elbow contractures that were treated by physical therapy after orthopedic treatment. Functional outcome was presented in degree from 1 to 3 (Flynn). The difference in the grade at the beginning and the end of the therapy is statistically significant (t=16.38, p<0.001). 91.18 %, of the children had excellent result. Complex of various therapeutically physical procedures can significant improve range of motion of the elbow joint. .

scholarly journals Open Reduction of Supracondylar Humerus Fractures in Children for Failed Closed Reduction: Outcome of Delayed Treatment

2021 ◽  
Vol 53 (3) ◽  
pp. 143-147
Author(s):  
Yoyos Dias Ismiarto ◽  
◽  
Mahyudin ◽  
Adriel Benedict Haryono
Keyword(s):  
Closed Reduction ◽  
Open Reduction ◽  
Kirschner Wire ◽  
Early Group ◽  
Supracondylar Fractures ◽  
Delayed Treatment ◽  
Type Iii ◽  
Fractures In Children ◽  
Kirschner Wire Fixation ◽  
Supracondylar Humerus Fractures

Supracondylar fractures of the humerus are common in children and the advocated treatments for these fractures include closed reduction and percutaneous pinning. There are numerous debates on the intervention period selection for delayed treatment in children. This phenomenon is prevalent in regions with limited healthcare support. The objective of this study was to compare the outcome of early and late treatment groups, including preliminary presentations and the management of failed treatment. This was a prospective comparative study on early and late open reduction, featuring Kirschner wire fixation for Gartland type III supracondylar fracture of humerus in children aged less than 18 years. Patients from January 2018 to January 2019 were categorized into early and late groups (n=22 and n=26), consisting of 33 (86.8%) males and 15 (31.25%) females. Flynn’s criteria were used to evaluate them. The average time from injury to surgery was 50.24±23.5 hours in the early group and 373.79±89.23 hours in the late group (p<0.002). While the Bauman’s angle recorded after 12 weeks presented the values of 82.04 ± 5.18 and 77.38±6.43 (p=0.622) for the early and late groups, respectively. Pre-operative nerve injuries were observed only in 4 (8.33%) cases from the early group. The functional outcomes of both categories were not significantly different statistically (p=0.242). The outcome for children with supracondylar humerus fracture Gartland type III was satisfactory in both groups. In conclusion, treatment delay does not result in a difference in the outcome according to Flynn's criteria.

Sign in / Sign up

Export Citation Format

Share Document