scholarly journals DIFFERENTIAL THERAPEUTIC TACTICS FOR COMPLICATED METAPHYSICAL FRACTURES OF THE DISTAL HUMERUS IN CHILDREN

2020 ◽  
Vol 3 (13) ◽  
pp. 53-61
Author(s):  
I.R. Trutyak ◽  
O.V. Oboaranets
Keyword(s):  
Conservative Treatment ◽  
Group Treatment ◽  
Group Analysis ◽  
Distal Humerus ◽  
Supracondylar Fractures ◽  
Conservative Method ◽  
Negative Results ◽  
Results Of Treatment ◽  
Unified Protocol ◽  
Articular Fractures

Introduction: One of the most common injuries of the distal end of the humerus is through condylar and supraorbital fractures of the humerus, which account for 47.5-80% of all intra-articular fractures of the elbow in children [5,11,20]. Among the injuries of the distal humerus, condylar and supraorbital fractures are the most common and are one of the most common domestic injuries in children aged 3 to 12 years. Objective: to optimize the diagnosis and treatment tactics in children with complicated supragingival and supracondylar fractures of the humerus using the developed protocol scheme of medical care for victims with supragingival and supraglottic fractures of the humerus. Materials and methods: Our work is based on a retrospective analysis of the treatment of 255 patients treated at the Lviv City Children's Hospital for the period 2013-2017. Results: in the first group, conservative treatment was performed in 86 victims, which was 65.6% of the group. In 69 (80.2%) in the future conservative method of treatment remained the main. In 17 (19.8%) victims, the conservative method was replaced by surgery. In the second group, conservative treatment was performed in 72 cases, which was 58.1% of the group, but it was replaced by surgery only in 3 (4.2%) cases. Surgical treatment was performed in 62 (47.3% 0 victims of the first group and in 55 (44.3%) victims of the second group. Analysis of treatment results showed that in the first group complications were observed in 21.0% of cases, and in the second group Among the victims of the first group, anatomical complications were noted in 38.4%, and in the second group they were not present at all.Functional complications also prevailed in the first group, which was found in almost twice as often as in the second group. treatment in the first group was 9.2 ± 0.5 days, in the second group - 6.5 ± 0.4 days. Conclusions: Negative results of treatment are caused by the prevalence of complications of fractures of the distal humerus, high vulnerability of the post-traumatic elbow joint, as well as the fine anatomical organization of the distal humerus. The introduction of a unified protocol scheme for the treatment of condylar and supragingival fractures of the humerus in pediatric patients has significantly improved both the anatomical and functional outcomes of treatment of patients in this category.

scholarly journals DIAGNOSTIC TACTICS FOR TRANSCONDYLAR AND SUPRACONDYLAR FRACTURES OF THE HUMERUS IN CHILDREN

World Science ◽  
2021 ◽  
Author(s):  
Trutyak Ihor ◽  
Obaranets Oleh
Keyword(s):  
Pediatric Patients ◽  
Group Analysis ◽  
Supracondylar Fractures ◽  
Rotational Displacement ◽  
Clinical Hospital ◽  
Unified Protocol ◽  
Pediatric Traumatology ◽  
The Difference ◽  
Condylar Fractures ◽  
The City

Transcondylar and supracondylar fractures of the humerus in children are one of the most relevant and still not completely solved problems of modern pediatric traumatology. In the problem of condylar and supraorbital fractures of the humerus, the issues of diagnosis, choice of indications for surgical revision of the vascular-nervous bundle of the elbow area in this pathology are insufficiently covered. To solve the problems of the study, we analyzed the treatment of 313 victims with transcondylar and supracondylar fractures of the humerus, which were treated at the City Children's Clinical Hospital in Lviv in the period from 2013 to 2018. The structure of the distribution of arrays on the basis of rotational displacement in condylar fractures of the humerus is dominated by displacement up to 30°, which in the first group was found in 61.8% of cases, and in the second group - 69.2% of cases. The share of severe rotational displacements in the structure of group arrays is almost the same in both observation groups: 29.1% in the first group and 29.5% in the second group. Analysis of the proportion of extremely severe rotational displacements up to 90° in the structure of group arrays revealed that such victims were 7 times more among the victims of the first group than among the victims of the second group, due to the use of the proposed unified protocol scheme for diagnosis and treatment humeral fractures in pediatric patients, which avoids or reduces the difference in the occurrence of secondary displacements.

scholarly journals EVALUATION OF EFFECTIVENESS OF PERCUTANEOUS VERTEBROPLASTY IN COMPLEX TREATMENT OF OSTEOPOROSIS WITH PATHOLOGICAL VERTEBRAL FRACTURES

2010 ◽  
Vol 16 (2) ◽  
pp. 93-96
Author(s):  
D. S. Astapenkov
Keyword(s):  
Conservative Treatment ◽  
Vertebral Fractures ◽  
Group Treatment ◽  
Percutaneous Vertebroplasty ◽  
Complex Treatment ◽  
Treatment Results ◽  
Pathological Fractures ◽  
Treatment Of Osteoporosis ◽  
Results Of Treatment

The effectiveness of vertebroplasty in treatment of 84 patients with osteoporosis and pathological fractures of the vertebrae was evaluated. 68 patients of the first group were underwent a comprehensive conservative treatment, percutaneous vertebroplasty was performed additionally in 16 patients in second group. The study found that in the second group treatment results were slightly better: the investigated parameters showed a significant dynamics, ie, vertebroplasty improved the results of treatment of osteoporotic patients with pathological fractures of the vertebrae.

scholarly journals Failure analysis and recommendations for treatment of posttraumatic non-unions of the distal humerus during childhood

2021 ◽  
Vol 47 (2) ◽  
pp. 313-324 ◽  
Author(s):  
Dirk Walther Sommerfeldt ◽  
Peter Paul Schmittenbecher
Keyword(s):  
Failure Analysis ◽  
Revision Surgery ◽  
Distal Humerus ◽  
Implant Removal ◽  
Supracondylar Fractures ◽  
Stable Fixation ◽  
Non Union ◽  
Pediatric Traumatology ◽  
Clinical Cases

Abstract Purpose Non-unions of the distal humerus are rare complications of common children’s fractures such as radial condyle fractures and supracondylar fractures. The aim of this paper was to update the knowledge about etiology, reasons, management, and results of these troublesome, and sometimes debilitating entities. Methods The sparse literature concerning nonunions following condylar or supracondylar fractures was analyzed together with the presentation of some typical clinical cases. Results In most of the cases, non-unions were induced by neglect, unstable fixation, too early implant removal, too much revision surgery, and an inconsequent transfer of follow-up algorithms, or combinations of the above. Treatment of non-union should start as early as possible because the effort of required surgery increases with time that the nonunion has been neglected. Often a combination of stable fixation of the pseudarthrosis and correction of the elbow axis are necessary to achieve a satisfying outcome. Conclusion In pediatric traumatology, qualified and consequent care for children’s fractures of the distal humerus can prevent rare complications such as non-unions in almost any situation. If such a disturbance of healing is noticed, immediate and adequate, i.e. children specific surgical consequences achieve best results.

Community Group Analysis: A Post-Crisis Synthesis

2003 ◽  
Vol 36 (2) ◽  
pp. 228-241 ◽  
Author(s):  
Mark B. Borg
Keyword(s):  
Mentally Ill ◽  
Group Treatment ◽  
World Trade ◽  
World Trade Center ◽  
Group Analysis ◽  
Traumatic Experiences ◽  
Community Group ◽  
World Trade Center Disaster ◽  
The World ◽  
Trade Center

This article describes some ideas, theoretical and clinical, related to group treatment of residents in a New York City homeless shelter for mentally ill persons immediately subsequent to the World Trade Center disaster. I provide details concerning this group as it dealt with community-level crises that were both acute, as they related to the World Trade Center disaster, and chronic, as they dealt with the ongoing condition of being mentally ill and homeless. I discuss my experience in the group and the ways that a synthesis of group, interpersonal psychoanalytic, and community psychology principles formed a framework for working through traumatic experiences in this community.

scholarly journals Initial Effectiveness Evaluation of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders for Homeless Women

2020 ◽  
pp. 014544552098256
Author(s):  
Sara Rodriguez-Moreno ◽  
Todd J. Farchione ◽  
Pablo Roca ◽  
Carolina Marín ◽  
Ana I. Guillén ◽  
...  
Keyword(s):  
Negative Affect ◽  
Emotional Disorders ◽  
Group Treatment ◽  
Linear Trend ◽  
Control Period ◽  
Well Being ◽  
Homeless Women ◽  
Depression And Anxiety ◽  
Transdiagnostic Treatment ◽  
Unified Protocol

The purpose of this study is to evaluate the effectiveness of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders adapted for homeless women (UPHW). Eighty-one homeless women participated in this single-blinded quasi-experimental clinical trial, involving up to 12 sessions of group treatment, and 3-and 6-month follow-ups. The participants received either immediate treatment with the UPHW ( n = 46) or delayed treatment, following a 12-week wait-list control period (WLC; n = 35). Primary outcomes included depression and anxiety. Secondary measures comprised positive and negative affect, psychological well-being, health perception, and social support. The UPHW resulted in significant improvement on measures of anxiety, depression and negative affect. Improvements in anxiety and depression were maintained over a 3-month follow-up period, but not at 6-month. The reliability of the clinical changes showed significant differences between UPHW and WLC for depression. Moreover, the inter-session assessment in the UPHW group showed a linear trend reduction for depression and anxiety scores along the 12 sessions. The clinical implications on the UPHW in social settings are also discussed.

scholarly journals Conservative Treatment in Intra-Articular Fractures of the Distal Radius: A Study on the Functional and Anatomic Outcome in Elderly Patients

2003 ◽  
Vol 44 (5) ◽  
pp. 836 ◽  
Author(s):  
Avni Dayican ◽  
Vuslat Sema Unal ◽  
Bulent Ozkurt ◽  
Suleyman Portakal ◽  
Ertugrul Nuhoglu ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Elderly Patients ◽  
Distal Radius ◽  
Articular Fractures

scholarly journals THE TREATMENT OF EXTRA- AND INTRA-ARTICULAR FRACTURES THE DISTAL HUMERUS

2010 ◽  
Vol 16 (3) ◽  
pp. 96-102
Author(s):  
V. V. Klyuchevsky ◽  
Hassan Ben El Hafi
Keyword(s):  
Soft Tissues ◽  
Functional Results ◽  
Distal Humerus ◽  
Distal Segment ◽  
Rigid Fixation ◽  
Performance Score ◽  
Mayo Elbow Performance Score ◽  
Articular Fractures ◽  
Active Mobilization ◽  
Violent Acts

From 2005 to 2009 we treated 112 patients with fractures of distal segment of the humerus, 83 (74,10%) of them were injured when falling from the height of its own growth, 8 (7,14%) - in an accident, 6 (5,35%) - a fall from a height, 13 (11,6%) - in sports, and two - as a result of violent acts. In 97 (87%) cases the fractures were closed, in 15 (13%) - open. 19 patients were treated conservatively and 93 - operatively. Functional results were evaluated using the Mayo elbow performance score (MEPS) in 78,37% of patients. Results of the conservative method: excellent and good - 46,66%, and in all patients with type A without displacement - in 100%. The fair results - in 33% and the poor in 20% - with type В and C. The results of operative treatment: excellent and good - 90,41%, the fair results - in 9,58%, no poor results. Initial prevent the oedema and bleeding into joints and soft tissues, adequate rigid fixation of fractures with the maximal restoration of the elbow joint congruent without additional immobilization and early active mobilization is essential to prevent the elbow stiffness and achieve a good outcomes.

scholarly journals Assessment of treatment for functional posterior cross-bites in patients at the deciduous dentition phase

2004 ◽  
Vol 15 (1) ◽  
pp. 54-58
Author(s):  
André Luiz Tannus Dutra ◽  
Antônio Carlos Cardoso ◽  
Arno Locks ◽  
Ana Cristina Barreto Bezerra
Keyword(s):  
Group Treatment ◽  
Control Group ◽  
Deciduous Dentition ◽  
Results Of Treatment ◽  
Group 2 ◽  
Group 1

The aim of this study was to clinically assess the results of treatment for functional posterior cross-bites by means of selective grinding in individuals at the deciduous dentition phase over a period of 12 months. From a total of 1,011 children examined in the 2-to-6-year age bracket, 26 with functional posterior cross-bites were selected. The sample was divided into 2 groups of 13 children each, group 1 receiving the treatment proposed and group 2 serving as the control group. Treatment was followed up by exercises designed to alter the children's muscular memory. The results showed that correction of functional posterior cross-bite was achieved for all the children treated, the correction remaining stable 12 months later. No self-correction of malocclusion occurred among the control group.

scholarly journals Comparison of cross pinning versus lateral three pins in type three supracondylar fracture of distal humerus in children.

2019 ◽  
Vol 10 (2) ◽  
pp. 58-61
Author(s):  
Krishna Sapkota ◽  
Krishna Wahegaonkar ◽  
Niraj Ranjeet ◽  
Pabin Thapa ◽  
Upendra Jung Thapa ◽  
...  
Keyword(s):  
Nerve Injury ◽  
Ulnar Nerve ◽  
Distal Humerus ◽  
Supracondylar Fracture ◽  
Good Stability ◽  
Lateral Side ◽  
Supracondylar Fractures ◽  
Wire Fixation ◽  
Ulnar Nerve Injury ◽  
K Wires

Background: Supracondylar fracture of distal humerus is the most common paediatric fracture. Type III supracondylar fractures should be treated with anatomical reduction and stable Kirschner wire (K- wire, pin) fixation to prevent the cosmetic deformity. The configuration of wires is debatable. Although two crossed K-wires are bio-mechanically stable, there is a risk of iatrogenic ulnar nerve injury. Lateral 3 K-wires is a good alternative. This study was done to compare the outcome of cross K- wire and lateral 3 K-wires in terms of stability. Materials and Methods: This is a prospective study done in Manipal Teaching Hospital. All the Gartland type 3 supracondylar fractures of the distal humerus were treated with closed reduction and stabilized with K wires. In Group I, fractures were stabilized with cross K wire fixation and in group II they were stabilized with 3 lateral K-wires. The patients were followed up at 4-5 weeks for wire removal and at 3 months and 6 months after surgery. Baumann's angle, a functional outcome as per Flynn's criteria, and range of motion were recorded in each visit. Outcomes were compared in term of displacement of fracture. Result: Seventeen children in each group were taken up for the study. There were no significant differences in term of patients and fracture character. No patients had significant loss of reduction at final follow up. There is no statistically significant difference seen in mean changes of Bauman's angle. According to Flynn's criteria good result was seen in more than 95% of cases in both groups. Conclusion: Both cross K-wires and Lateral 3 K-wires provide good stability. Fixation of supracondylar fracture from lateral side had an advantage of no risk of iatrogenic Ulnar nerve injury. Addition of third K-wire from lateral side provides good stability as that of cross K- wire fixation.

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