scholarly journals Intramedullary Nailing for Paediatric Diaphyseal Forearm Bone Fracture

2012 ◽  
Vol 9 (3) ◽  
pp. 198-202 ◽  
Author(s):  
N P Parajuli ◽  
D Shrestha ◽  
D Dhoju ◽  
G R Dhakal ◽  
R Shrestha ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Bone Fracture ◽  
Closed Reduction ◽  
Open Reduction ◽  
Forearm Fracture ◽  
Skin Irritation ◽  
Pediatric Age Group ◽  
Superficial Skin ◽  
Reduction Methods ◽  
Forearm Bone

Background Though most of the pediatric diaphyseal forearm bone fracture can be treated with closed reduction and cast application, indications for operative intervention in pediatric both-bone forearm fractures include open fractures, irreducible fractures, and unstable fractures. Controversy exists as to what amount of angulation, displacement, and rotation constitutes an acceptable reduction. Objective To review union time and functional outcome of pediatric diaphyseal forearm bone fracture managed with intramedullary rush pin by closed or open reduction. Methods Fifty patients with both bone fracture of forearm were treated with intramedullary rush pin by closed or open reduction were included in the study and followed up for minimum six months for radilological and functional outcome. Results Out of 50 patients, 31 underwent closed reduction and 19 underwent open reduction. All fractures maintained good alignment post operatively. Forty seven patients had excellent results with normal elbow range of motion and normal forearm rotation and three patients had good results. In all patients good radiological union was seen in three months time. Eight patients had minor complications including skin irritation over prominent hardware, backing out of ulnar pin, superficial skin break down with exposed hardware. Twenty-three (46%) patients had undergone implant removal at an average of 6 months (range 4-8 months) under regional or general anesthesia Conclusion Fixation with intramedullary rush pin for forearm fracture is an effective, simple, cheap, and convenient way for treatment in pediatric age group. DOI: http://dx.doi.org/10.3126/kumj.v9i3.6305 Kathmandu Univ Med J 2011;9(3):198-202 

scholarly journals Elastic stable intramedullary nailing in pediatric diaphyseal forearm bone fracture

2017 ◽  
Vol 3 (2) ◽  
pp. 190
Author(s):  
Poojan Kumar Rokaya ◽  
Mangal Rawal ◽  
Javed Ahmad Khan ◽  
Praveen Kumar Giri
Keyword(s):  
Intramedullary Nailing ◽  
Bone Fracture ◽  
Closed Reduction ◽  
Forearm Fracture ◽  
Minimal Invasive ◽  
Elastic Stable Intramedullary Nailing ◽  
Forearm Bones ◽  
Average Loss ◽  
Forearm Bone ◽  
Elastic Intramedullary Nailing

<p class="abstract"><strong>Background:</strong> Pediatric forearm bone fracture present significant challenges where most of them are managed with closed reduction and casting. Irreducible, unstable and open fracture usually requires operative stabilization. Intramedullary nailing is considered minimal invasive however it is not free of complication. The aim of this study is to analyze the outcome and complications after elastic stable intramedullary nailing in pediatric diaphyseal forearm fracture<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> A descriptive observational study was carried out for four years (2013-2016) in diaphyseal pediatric forearm fracture stabilized with titanium elastic stable intramedullary nailing. Final range of motion, complications and outcome were assessed using Clavien-Dindo classification modification appropriate for orthopedic surgery.<strong></strong></p><p class="abstract"><strong>Results:</strong> We report the outcome of 36 patients with complete medical records. Closed reduction and nailing was successful in 25 patients (69.4%) whereas eleven patients (30.6%) required open reduction (both radius and ulna in 6 patients 16.7%, ulna in 3 patients 8.3% and radius in 2 patients 5.6%). Radiological union was achieved at an average of 7.75±1.5 weeks (range 6 to 16 weeks). Forearm rotation was limited in 7 patients with average loss of 16° pronation and 18° supination. The overall rate of complication was 22.2%. According to Clavien-Dindo classification excellent results were noted in 29 patients (80.6%), good in 3 patients (8.3%) and fair in 4 patients (11.1%)<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> Elastic intramedullary nailing in pediatric diaphyseal forearm bones fracture is minimally invasive with low rate of complication and the outcomes are fair to excellent<span lang="EN-IN">.</span></p>

scholarly journals Outcome of Intramedullary Stainless steel Rush pins for the treatment of Pediatric diaphyseal forearm bone fracture

2016 ◽  
Vol 12 (2) ◽  
pp. 50-54
Author(s):  
Poojan Kumar Rokaya ◽  
Mangal Rawa ◽  
Javed Ahmad Khan
Keyword(s):  
Stainless Steel ◽  
Bone Fracture ◽  
Open Reduction ◽  
Bone Fractures ◽  
Plate Fixation ◽  
Excellent Result ◽  
Forearm Fracture ◽  
Intramedullary Fixation ◽  
Fractures In Children ◽  
Forearm Bone

Background & Objectives: Pediatric forearm bone fractures are common orthopedic injuries. Generally, these fractures can be successfully managed with closed reduction and casting however operative fixation may be required. Currently, the most common operative interventions are open reduction with plate fixation versus closed or open reduction with intramedullary fixation. Intramedullary fixation materials include Steinmann pins, Kirschner-wires, Rush pins, and elastic titanium nails. To demonstrate the outcome of Intramedullary Stainless steel Rush pins for the treatment of Pediatric diaphyseal forearm bone fracture.Materials & Methods: This study included thirty children with diaphyseal forearm bone fracture treated with intramedullary stainless steel rush pin. Patient’s age, sex, side, mode of injury, fracture type, fixation indication and method, time of clinical and radiological union, complication rate and final range of motion were evaluated at subsequent follow up­. Clinical evaluation was done as per Price’s criteria. Results: Among 30 patients there were 22 boys (73.3%) and 8 girls (26.6%) with a mean age of 11.8 years (Range, 5 to14 years). Twenty (66.6%) patients had right forearm fracture, 10 (33.3%) patients had left forearm fracture. Union was obtained in a mean of 6.5±1.0 weeks (range 6 to 9 weeks). According to the criteria of Price et al. an excellent result was achieved in 25 patients (83.3%) and a good result in five patients (16.6%). Out of total 30 patients six (20%) had minor complications. Conclusion: Fixation with intramedullary stainless steel rush pin produces good to excellent results in diaphyseal forearm bone fractures in children. Based on our experience, rush pins are simple, safe, easily available and affordable to most of the patients in developing countries.JCMS Nepal. 2016;12(2):50-4

scholarly journals Comparison of outcome of closed reduction and percutaneous pinning and, open reduction and internal fixation with k-wire in Gartland extension type III supracondylar fracture of distal humerus in pediatric population

2018 ◽  
Vol 1 (1) ◽  
pp. 1-3
Author(s):  
Bhogendra Bahadur KC ◽  
Norman Lamichhane ◽  
Chandra Bahadur Mishra ◽  
Bharat Bahadur Khatri ◽  
Sabita Dhakal
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Closed Reduction ◽  
Open Reduction ◽  
Operative Procedure ◽  
Distal Humerus ◽  
Supracondylar Fracture ◽  
P Value ◽  
Percutaneous Pinning ◽  
Type Iii

Background: Supracondylar fracture of the distal humerus is one of the commonest fracture in pediatric age group. Though there is consensus of treating type III fracture operatively, no study has compared the outcome between Closed Reduction and Percutaneous Pinning (CRPP) and Open Reduction and Internal Fixation (ORIF) with k-wire in our setup. Materials and Methods: Retrospective comparison study was done on eighty seven cases of Type III supracondylar fracture of distal humerus underwent operative procedure. Fifty four (54) cases underwent CRPP and 33 cases were managed with ORIF with k-wire, and they were followed up till 6 months post-operatively. Results : The mean time for radiological union in patient who underwent CRPP was 4.37±0.94 weeks and that for the patient who underwent ORIF was 4.45±0.13 weeks, the difference of which was statistically insignificant (p-value >0.05). 83.3% of CRPP group and 78.8% in ORIF group had excellent functional outcome and only 3% in ORIF group had poor functional outcome. Conclusion: Though both the group don’t have significant advantage of functional outcome among each other CRPP with limited attempt should be preferred to ORIF with k-wire for the advantage of avoiding surgical scar and reducing surgery time and exposure to anaesthetic agents.

scholarly journals Management of isolated distal end of radius fracture in pediatric age group: An observational study

2021 ◽  
Vol 12 (9) ◽  
pp. 130-135
Author(s):  
Vishwas Sharad Phadke ◽  
Ajaykumar R Allamwar ◽  
Vaibhav V Antrolikar
Keyword(s):  
Observational Study ◽  
Internal Fixation ◽  
Functional Outcome ◽  
Closed Reduction ◽  
Radius Fracture ◽  
Dominant Hand ◽  
Age Group ◽  
Pediatric Age ◽  
Mechanism Of Injury ◽  
Pediatric Age Group

Background: Fractures of the distal radius are one of the common fractures for which pediatric orthopedic consultations are sought. The usual mechanism of injury is fall on outstretched hand seen following a road traffic accident or fall. Most of these fractures are treated either conservatively or by closed reduction and immobilization in cast. In some cases, internal fixation by K-wiring may be required. We conducted this study to analyzed outcome of distal end radius fracture in pediatric age group who were treated by immobilization alone, by closed reduction and immobilization and closed reduction with internal fixation by K-Wire and immobilization in cast. Aims and Objectives: 1. To analyze outcome of distal end radius fracture in pediatric age group. 2. To study complications in children presenting with distal end radius fracture. Materials and Methods: This was an observational study conducted in the department of orthopedics of a tertiary care medical college. 60 pediatric patients with distal radius fractures and treated either by conservative management or by surgical intervention were included in this study on the basis of a predefined inclusion and exclusion criteria. Gender distribution, mean age and mechanism of injury in the affected cases were analyzed. Patients were treated either by immobilization alone, by closed reduction and immobilization and closed reduction with internal fixation by K-Wire and immobilization in cast. Patients were followed up for 8 weeks. Complications and time for complete union was assessed during follow up visits. Functional outcome was assessed by QuickDash Score. Results: Out of these 60 patients there were 52 (86.66%) males and 8 (13.33%) females with a male to female ratio of 1:0.15. The mean age of affected cases in Boys and Girls was found to be 13.09 +/- 2.93 years and 12.5+/- 3.64 years respectively. Dominant hand was involved in 41 (68.33 %) whereas non-dominant hand was involved in remaining 19 (31.66 %) cases. In 16 (26.67%) patients only casting was required whereas closed reduction and casting was done in 25 (41.67%) patients in remaining 19 (31.67%) patients closed reduction and K-Wire fixation was done. 42 (70%) patients had excellent functional outcome whereas 9 (15%) patients had good functional outcome and 9 (15%) patients were found to have satisfactory outcome. 4 (6.66%) patients developed pressure sores, 1 (1.67%) patient had stiffness and there was 1 (1.67%) case of pin site infections. All these complications were successfully managed by conservative means. Conclusion: Fractures of distal end of radius in pediatric age group can be managed successfully either by immobilization alone or by closed reduction and casting. Internal Fixation by K-Wires may be required in some cases.

IRREDUCIBLE METACARPAL NECK FRACTURE CAUSED BY INTERPOSITION OF JUNCTURA TENDINUM

Hand Surgery ◽  
2014 ◽  
Vol 19 (03) ◽  
pp. 441-443 ◽  
Author(s):  
Duk Hee Lee ◽  
Jong Woong Park ◽  
Jung Il Lee
Keyword(s):  
Closed Reduction ◽  
Open Reduction ◽  
Reduction Technique ◽  
The Third ◽  
Neck Fracture ◽  
Reduction Methods ◽  
Cause Of Failure ◽  
Intermetacarpal Space ◽  
Do So

Most metacarpal neck fractures can be reduced using the close reduction technique. However, if acceptable reduction cannot be achieved by closed reduction, open reduction is indicated. A 37-year-old patient had a third metacarpal neck fracture. We tried to reduce the metacarpal neck fracture by using closed reduction methods, but failed to do so. We performed open exploration and observed that the cause of failure was interposition of the junctura tendinum (JT) connecting the third and fourth extensor digitorum tendons. The JT in the third or fourth intermetacarpal space can interpose between the fragments in cases of third, fourth, or fifth metacarpal neck fractures, because the JT in the third or fourth intermetacarpal space is thick and wide (type 2 or 3). The JT in the third or fourth intermetacarpal space should be considered as a potential obstacle to the reduction in cases of irreducible metacarpal neck fractures.

scholarly journals Ipsilateral Supracondylar Fracture and Forearm Bone Injury in Children: A Retrospective Review of Thirty one Cases

2012 ◽  
Vol 9 (2) ◽  
pp. 11-16 ◽  
Author(s):  
D Dhoju ◽  
D Shrestha ◽  
N Parajuli ◽  
G Dhakal ◽  
R Shrestha
Keyword(s):  
Bone Fracture ◽  
Closed Reduction ◽  
Supracondylar Fracture ◽  
Radius Fracture ◽  
Type I ◽  
Type Iii ◽  
Bone Injury ◽  
Wire Fixation ◽  
Forearm Bone ◽  
Floating Elbow

Background Supracondylar fracture and forearm bone fracture in isolation is common musculoskeletal injury in pediatric age group But combined supracondylar fracture with ipsilateral forearm bone fracture, also known as floating elbow is not common injury. The incidence of this association varies between 3% and 13%. Since the injury is rare and only limited literatures are available, choosing best management options for floating elbow is challenging. Method In retrospective review of 759 consecutive supracondylar fracture managed in between July 2005 to June 2011, children with combined supracondylar fracture with forearm bone injuries were identified and their demographic profiles, mode of injury, fracture types, treatment procedures, outcome and complications were analyzed. Result Thirty one patients (mean age 8.91 yrs, range 2-14 yrs; male 26; left side 18) had combined supracondylar fracture and ipsilateral forearm bone injury including four open fractures. There were 20 (64.51%) Gartland type III (13 type IIIA and 7 type III B), seven (22.58 %) type II, three (9.67 %) type I and one (3.22 %) flexion type supracondylar fracture. Nine patients had distal radius fracture, six had distal third both bone fracture, three had distal ulna fracture, two had mid shaft both bone injury and one with segmental ulna with distal radius fracture. There were Monteggia fracture dislocation, proximal ulna fracture, olecranon process fracture, undisplaced radial head fracture of one each and two undisplaced coronoid process fracture. Type I supracondylar fracture with undisplaced forearm were treated with closed reduction and long arm back slab or long arm cast. Displaced forearm fracture required closed reduction and fixation with Kirschner wires or intramedullary nailing. Nineteen patients with Gartland type III fracture underwent operative intervention. Among them nine had closed reduction and K wire fixation for both supracondylar fracture and forearm bone injury. One patient with closed reduction and long arm cast application for both type III supracondylar fracture and distal third radius fracture developed impending compartment syndrome and required splitting of cast, remanipulation and Kirschner wire fixation. There were three radial nerve, one ulnar nerve and one median nerve injury and two postoperative ulnar nerve palsy. Three patients had pin tract related complications. Among type III, 16 (80%) patients had good to excellent, two had fair and one gad poor result in terms of Flynn’s criteria in three months follow up ConclusionDisplaced supracondylar fracture with ipsilateral displaced forearm bone injuries need early operative management in the form of closed reduction and percutaneous pinning which provides not only stable fixation but also allows close observation for early sign and symptom of development of any compartment syndrome.DOI: http://dx.doi.org/10.3126/kumj.v9i2.6280 Kathmandu Univ Med J 2011;9(2):11-16 

scholarly journals Comparative study of closed reduction vs. open reduction fixed with k-wiring in type 3 displaced supracondylar fractures in children

2017 ◽  
Vol 3 (5) ◽  
pp. 1010
Author(s):  
Mahesh D. V. ◽  
Deepak C. D. ◽  
Abdul Ravoof ◽  
Shruthikanth .
Keyword(s):  
Closed Reduction ◽  
Open Reduction ◽  
Age Group ◽  
Supracondylar Fractures ◽  
Aggressive Approach ◽  
Fractures In Children ◽  
Reduction Methods ◽  
Group A ◽  
Group B ◽  
Type 3

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Among all the fractures in upper limb in children, supracondylar fractures of the humerus are more common injuries. In general the fractures of children are treated conservatively. But the management of supracondylar fractures has evolved over years from conservative to more aggressive approach operative techniques.</span></p><p class="abstract"><strong>Methods:</strong> The study was conducted in children's presenting with type 3 Gartland supracondylar fractures to Adichunchanagiri Institute of Medical Sciences, B. G. Nagara between January 2014 to December 2016.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">The study consisted of 40 type 3 supracondylar fractures cases. Group A (closed reduction) had 25 cases, among them were 20 males and 5 were females. Group B (open reduction) had 15 cases among them 12 males and 3 female cases. The patients were between the age of 6 to12 years. In Group A, 19 children were in the age group of 6-10 years where as Group B had 12 cases. In Group A, 6 were in the age group of 10-12 years and 3 cases in Group B. Among the 25 cases in Group A, 19 were left sided and 6 were right sided. In group B, 11 were left sided and 4 were right sided. All patients had achieved clinical and radiological union at 4 weeks. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Closed reduction and k-wiring had very good results for type 3 supracondylar fractures of humerus in children than conservative/open reduction methods. However for cases which we didn't get proper/satisfactory reduction in closed method, open method with triceps splitting approach was used.</span></p>

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