Closed reduction and percutaneous fixation of supracondylar fracture of the humerus and ipsilateral fracture of the forearm in children

Tabak, Yalçın; Çelebi, Levent; Murath, H. H.; Yağmurlu, Mehmet Fırat; Aktekin, Cem Nuri; Biçimoğlu, Ali

doi:10.1302/0301-620x.85b8.14015

Cited by 29 publications

(30 citation statements)

References 19 publications

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“…The incidence of associated nerve injuries (40%) and of open fractures (40%) was higher than expected because of the severity of the injury [23,25]. Tabak AY recommended conservative treatment of the nerve injuries as spontaneous resolution may be expected [26]. While majority of isolated displaced supracondylar fractures of the humerus are managed with closed reduction and percutaneous fixation, the treatment of a supracondylar fracture in the presence of an ipsilateral forearm fracture is still controversial [7,12,14,15,25].…”

Section: Discussionmentioning

confidence: 99%

Ipsilateral fracture of the supracondylar humerus and forearm in children

Hussain¹

2014

IJCRI

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International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations.IJCRI publishes Review Articles, Case Series, Case Reports, Case in Images, Clinical Images and Letters to Editor. Website: www.ijcasereportsandimages.comIpsilateral fracture of the supracondylar humerus and forearm in children Shahid Hussain ABSTRACT Introduction: Simultaneous ipsilateral fracture of the elbow and forearm (floating elbow) is an uncommon injury and treatment recommendations are controversial. The aim of our study was to evaluate the incidence of ipsilateral fractures of the upper limb and to present our experience in dealing with such injuries and to review the literature relating to this topic. The following variables were used: age, gender, side, mechanism of injury, type of fracture, classification, treatment methods, complications and outcome. Case Series: We prospectively followed five children who presented with displaced supracondylar fractures of the humerus associated with a forearm fracture of the same limb. All patients underwent emergency procedures in the form of closed reduction and K-wire fixation/ cast fixation. At a minimum follow up of 24 months, all patients were assessed clinically and radiologically and the results evaluated according to a conventional scoring system. Four patients had excellent or good outcomes, and there was one poor result. Conclusion:The floating elbow is an indicator of a high energy injury. The incidence of open fractures, compartment syndrome and nerve injury and the need to perform an open reduction were higher than those recorded for isolated supracondylar or forearm fractures. The existing controversies in the management of such a complex injury and associated problems are outlined. A pertinent literature review is also included.

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Section: Discussionmentioning

confidence: 99%

Ipsilateral fracture of the supracondylar humerus and forearm in children

Hussain¹

2014

IJCRI

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“…All the displaced distal radius fractures underwent closed reduction and K-wire fixation using 2 crossed wires. 2,3,9 All procedures were done in accordance with ethical standards. Postoperatively, the limb was immobilised in above elbow cast with forearm in supination except in the open fracture where elbow spanning external fixator was applied.…”

Section: Methodsmentioning

confidence: 99%

“…2 Another article reported 22 patients with ipsilateral supracondylar and forearm fracture with 6 patients having radius fracture. 3 Apart from above-mentioned data, few sporadic cases are reported having the above-mentioned type of injury. 6,4,7 K-wire fixation for both radius and supracondylar humerus if the fracture is displaced (Gartland type II and Type III).…”

Section: Introductionmentioning

confidence: 99%

“…1,2,3,4 We have treated ten patients with ipsilateral supracondylar humerus fracture with distal radius fracture. One had a Gustilo-Anderson Grade 2 open supracondylar humerus fracture.…”

Section: Introductionmentioning

confidence: 99%

“…The incidence varies from 2 to 13% as cited in various articles. 1,2,3,4 One article has reported 9 cases of isolated distal radius fracture out of 31 cases with ipsilateral supracondylar humerus and forearm fracture studied retrospectively over a period of 5 years. 1 Other article reported 4 distal radius fractures out of 8 (11.1%) patients with ipsilateral forearm with supracondylar humerus fracture.…”

Section: Introductionmentioning

confidence: 99%

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Ipsilateral Supracondylar Humerus Fracture With Distal End Radius Fracture - A Review of 10 Cases

Singh¹,

Ramteke²,

Mangukiya³

2016

jemds

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BACKGROUNDSupracondylar humerus fracture with forearm fractures are rare with reported incidence ranging from 3% to 13%. 1,2,3,4 We have treated ten patients with ipsilateral supracondylar humerus fracture with distal radius fracture. One had a Gustilo-Anderson Grade 2 open supracondylar humerus fracture. All displaced fractures were treated with K-wire fixation by closed method except the open fracture which warranted wound debridement and subsequent open reduction. A follow-up of at least 6 months is available for all our patients. All fractures showed signs of union by 6 weeks when K-wires were removed. At 6 months, 9 patients had excellent outcome while one patient with recovering radial nerve palsy had fair outcome. No cases of mal-union, non-union, loss of reduction were seen in the post-operative period. Pin tract site infection was seen in one patient with open fracture which resolved after Kwire removal and antibiotic coverage. This study recommends a screening x-ray of forearm and wrist in patients with supracondylar humerus fractures to rule out any associated forearm/wrist injury. We also recommend closed reduction and K-wire fixation of the displaced supracondylar humerus as well as distal radius fractures. Any nerve palsy if present should be conservatively managed and should be observed for at least 6 weeks before considering surgical exploration.

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