scholarly journals Factors influencing the complication rate in pediatric supracondylar humerus fractures

2019 ◽  
Vol 11 (2) ◽  
Author(s):  
Daniel Körner ◽  
Florian Laux ◽  
Ulrich Stöckle ◽  
Christoph Gonser
Keyword(s):  
Surgical Treatment ◽  
Influencing Factors ◽  
Complication Rate ◽  
High Rate ◽  
Related Factors ◽  
Conservative And Operative Treatment ◽  
Early Revision ◽  
Pin Fixation ◽  
Supracondylar Humerus Fractures ◽  
Humerus Fractures

The aim of the study was to identify influencing factors on the complication rate in pediatric supracondylar humerus fractures (PSHF). 22 male and 19 female patients with an extension type PSHF underwent conservative and operative treatment at a single trauma department and were reviewed retrospectively. The complications were assessed and the groups of patients with and without complications were compared according to patient- and therapy-related factors. The overall complication rate was 19.5%. Two patients had a primary and 4 patients a postoperative neurological deficit. One patient developed a pin infection after open reduction and crossed pin fixation. One patient underwent early revision surgery because of insufficient initial reduction after closed reduction and crossed pin fixation. All complications appeared in the surgical treatment group. The appearance of complications was significantly associated with a higher Gartland stage. The median time between trauma and operation was significantly longer in patients without compared to patients with complications. PSHF are associated with a high rate of neurological complications. The Gartland stage and the necessity of surgical treatment are the major influencing factors on the complication rate.

scholarly journals Temporary Fixation of Reduction with Fabric Adhesive Bandage in the Surgical Treatment of Pediatric Supracondylar Humerus Fractures

Medicina ◽  
2019 ◽  
Vol 55 (8) ◽  
pp. 450
Author(s):  
Turhal ◽  
Kınaş ◽  
Karaduman ◽  
Turhan ◽  
Kaya ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Closed Reduction ◽  
Lateral Entry ◽  
Chondral Damage ◽  
Supracondylar Humerus Fractures ◽  
Cosmetic Outcomes ◽  
Humerus Fractures ◽  
The Mean ◽  
Type 3 ◽  
Adhesive Bandage

Background and objectives: Supracondylar humerus fractures are common in children andcan be surgically treated. However, the general surgical procedures involving reduction andfixation might lead to reduction loss, failure to direct the Kirschner (K)-wire toward the desiredposition, prolonged surgery, or chondral damage. This study aimed to show that temporaryfixation of closed reduction with a fabric adhesive bandage in pediatric supracondylar humerusfractures could maintain reduction so that surgical treatment can be easily performed by a singlephysician. Materials and Methods: Forty-six patients with Gartland type 3 supracondylar humerusfractures who underwent surgical treatment between May 2017 and June 2018 were retrospectivelyevaluated. Fluoroscopy-guided reduction and fixation were performed from the distal third of theforearm to the proximal third of the humerus using a fabric adhesive bandage. Two crossed pinswere applied on the fracture line by first inserting a lateral-entry K-wire and then inserting anotherK-wire close to the anterior aspect of the medial epicondyle and diverging from the ulnar nervetunnel. A tourniquet was not applied in any patient and no patients required open reduction.Results: The study included 32 boys (69.6%) and 14 girls (30.4%) (mean age, 7.1; range, 2–16 years).The mean hospital stay and follow-up duration were 4.3 ± 3.9 days and 48.1 ± 14.3 weeks,respectively. Heterotopic ossification was detected in one patient, and ulnar nerve neuropraxia wasdetected in another patient. Functional (according to Flynn criteria) and cosmetic outcomes wereexcellent in 95.6%, moderate in 2.2%, and poor in 2.2% of patients. The mean duration of fixation ofthe closed reduction with a fabric adhesive bandage was 8.1 ± 3.9 min, and the mean duration ofpinning was 7.9 ± 1.4 min. Conclusions: Temporary preoperative fixation of supracondylar humerusfractures that require surgical treatment with a fabric adhesive bandage may be significantlyconvenient in practice.

scholarly journals Timing of surgical treatment for type III supracondylar humerus fractures in pediatric patients

2009 ◽  
Vol 3 (4) ◽  
pp. 265-269 ◽  
Author(s):  
Ahmet Ozgur Yildirim ◽  
Vuslat Sema Unal ◽  
Ozdamar Fuad Oken ◽  
Murat Gulcek ◽  
Metin Ozsular ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Pediatric Patients ◽  
Type Iii ◽  
Supracondylar Humerus Fractures ◽  
Humerus Fractures

scholarly journals Biomechanical Analysis of Crossed Pinning Construct on Supracondylar Fracture of Humerus in Children: Does Point of Crossing Matters?

2018 ◽  
Vol 17 (1) ◽  
Author(s):  
Mohd Aizat Azfar Bin Soldin ◽  
Mohd Shukrimi bin Awang ◽  
Ardilla Hanim Binti Razak
Keyword(s):  
External Rotation ◽  
Biomechanical Analysis ◽  
Point Location ◽  
Recommended Treatment ◽  
Pin Fixation ◽  
Supracondylar Humerus Fractures ◽  
Significant Difference ◽  
Humerus Fractures ◽  
The Stability ◽  
Crossing Point

Introduction: Percutaneous pin fixation either by crossed pinning construct (CPC) or lateral divergent pinning construct (LDPC) are the recommended treatment for displaced supracondylar humerus fractures (SCHF) in children. Several studies had compared the biomechanical stability between these two, however, a biomechanical analysis of varying crossing point location in CPC has not been performed previously. The aim of this study was to compare the stability of various crossing point location in CPC and LDPC. Materials and Methods: Thirty synthetic humeri were osteotomized at mid olecranon fossa, anatomically reduced and pinned using two 1.6 mm Kirschner wiresin five different constructs namely centre point, medial point, lateral point, superior point and LDPC. Six samples were prepared for each construct and were tested for extension, flexion, valgus, varus, internal rotation and external rotation forces by using Universal Tensile Machine and the data were analysed with R Statistic. Results: The centre point CPC was the stiffest while the LDPC and medial point CPC were the least stiff construct for linear and rotational force respectively. Lateral point CPC, and superior point CPC showed no statistically significant difference when compared to centre point CPC. Conclusion: The centre point CPC was the most stable construct while the LDPC and medial point CPC were the least stable. The stability of lateral point CPC and superior point CPC were statistically comparable to centre point CPC. Clinically, this will help the treating surgeon to reduce the numbers of attempt during K-wire insertion in order to get perfect centre point CPC.

Our Early Term Surgical Treatment Results in Pediatric Gartland Type 3 Supracondylar Humerus Fractures

2013 ◽  
Vol 5 (1) ◽  
pp. 27-31 ◽  
Author(s):  
Mehmet Erdil ◽  
Hasan Huseyin Ceylan ◽  
Necdet Demir ◽  
Nuh Mehmet Elmadag ◽  
Kerem Bilsel ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Treatment Results ◽  
Early Term ◽  
Supracondylar Humerus Fractures ◽  
Humerus Fractures ◽  
Type 3

scholarly journals Postponing surgery of paediatric supracondylar humerus fractures to office hours increases consultant attendance in operations and saves operative room time

2018 ◽  
Vol 12 (3) ◽  
pp. 288-293 ◽  
Author(s):  
N. Tuomilehto ◽  
A. Sommarhem ◽  
P. Salminen ◽  
A. Y. Nietosvaara
Keyword(s):  
Blood Circulation ◽  
Statistical Difference ◽  
Operation Time ◽  
Level Of Evidence ◽  
Pin Fixation ◽  
Supracondylar Humerus Fractures ◽  
Humerus Fractures ◽  
Group B ◽  
Room Time

Purpose To assess if postponing surgery of paediatric supracondylar humerus fractures (SCHF) without compromised blood circulation to office hours can improve the quality of reduction and pin fixation and decrease complications. Methods In 2004, night-time (0am to 7am) surgery was allowed only for children with compromised blood circulation. Number of open reductions, surgeons experience, operation time, quality of reduction (Baumann angle, anterior humeral line crossing point with capitellum) and pin fixation as well as the number of complications were compared in 100 children before (A) and 100 after (B) the new protocol. Surgery was commenced during office hours (8am to 3pm) in 27% (A) versus 55% (B) and delay to surgery from admission exceeded six hours in 25% (A) versus 52% (B) of the children. Results Open reduction was performed in eight (A) versus 11 (B) children. In group A, 40% were operated on by a registrar alone compared with 14% in group B. Mean operation room time decreased by 11 minutes in group B. Radiographic alignment was satisfactory at fracture union in 68% (A) versus 68% (B) and radiologically stable pin fixation in 42% (A) versus 55% (B) of children (p = 0.08). The was no statistical difference in admission time, re-reductions, infections, permanent iatrogenic nerve injuries or corrective osteotomies between the patient groups. Conclusions No statistical difference in quality of reduction or pin fixation or in number of complications was observed. Postponing operative treatment of SCHF without vascular compromise increased consultant attendance in operations and decreased operative room time. Level of Evidence III - retrospective comparative study

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