Early correction of malunited supracondylar humerus fractures in young children

Azzam, Wael; Catagni, Maurizio A.; Ayoub, Mostafa A.; El-Sayed, Mohamed; Thabet, Ahmed M.

doi:10.1016/j.injury.2020.08.023

Cited by 10 publications

(5 citation statements)

References 29 publications

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“…C ubitus varus alters the mechanical axis of the upper extremity and not only can be visually unappealing but also predisposes to functional disability and pain [9][10][11][12] . Acute corrective osteotomies with immediate fixation are associated with up to 25% complications, such as nerve injury, failure of fixation, recurrence of the deformity, overcorrection or undercorrection, lateral condylar prominence, dissatisfaction with residual scar, and loss of motion 13 .…”

Section: Discussionmentioning

confidence: 99%

“…The etiology of the deformity is primarily malunion of the distal humerus, in addition to physeal growth disturbances and osteonecrosis 9 . The deformity predisposes to posterolateral rotary instability, ulnar neuropathy, snapping triceps, loss of elbow range of motion, and elbow pain; hence, some authors advocate for intervention to correct this deformity 9-12 .…”

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confidence: 99%

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Correction of Cubitus Varus Using Computer-Assisted Hexapod Multiplanar External Fixators

Klahs

Polmear

Transtrum

et al. 2023

JBJS Case Connector

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Case: Three male patients, 8-, 13-, and 18-year-old, all developed posttraumatic cubitus varus elbow deformity after distal humerus supracondylar fractures. Each underwent a distal humerus osteotomy with application of a hexapod external fixator to gradually correct the deformity. Conclusion:In patients with cubitus varus malunion, the stability of the hexapod external fixation, percutaneous nature of the osteotomy, and availability of running a residual computer-assisted program provides a consistent technique for deformity correction. E lbow fractures are common in pediatric patients and can present in a wide spectrum of severity [1][2][3][4] . Cubitus varus deformity is the most common late complication resulting from supracondylar fractures with an incidence of 3% to 57% [5][6][7][8] . The etiology of the deformity is primarily malunion of the distal humerus, in addition to physeal growth disturbances and osteonecrosis 9 . The deformity predisposes to posterolateral rotary instability, ulnar neuropathy, snapping triceps, loss of elbow range of motion, and elbow pain; hence, some authors advocate for intervention to correct this deformity 9-12 . Fig. 1 Case 1. Fig. 1-A Anteroposterior elbow radiograph of injury. Fig. 1-B Lateral elbow radiograph of the injury. Fig. 1-C Status post open reduction and internal fixation anteroposterior elbow radiograph. Fig. 1-D Status post open reduction and internal fixation lateral elbow radiograph. Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSCC/ C13).

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Correction of Cubitus Varus Using Computer-Assisted Hexapod Multiplanar External Fixators

Klahs

Polmear

Transtrum

et al. 2023

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“…The older the school-age children can be more adapt well to the postoperative state of fractures and better cooperate with functional exercises. Children whose only children and their main caregivers are grandparents receive more attention in their daily lives, they have relatively poor tolerance to pain [ 34 ]. When they cannot maintain functional exercises, their caregivers are more likely to compromise, give up, thereby reducing the compliance [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Compliance of functional exercises in school-age children with limb fractures: implication for nursing countermeasures

Liu

Wang

et al. 2022

BMC Pediatr

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Background Functional exercises is very essential to the recovery of patients with fracture. We aimed to evaluate the compliance of functional exercises in school-age children with limb fracture, to provide evidence to the clinical management and nursing care of children with limb fracture. Methods School-age children with limb fractures treated in our hospital from January 1, 2020 to June 30, 2021 were selected. The characteristics and postoperative functional exercise compliance of included children were analyzed. Pearson correlation and Logistic regression analysis were conducted to analyze the influencing factors of compliance to functional exercises. Results A total of 328 children with limb fracture were included, the incidence of compliance to functional exercise was only 35.98%. Pearson correlation analysis showed that age(r = 0.707), only child of family(r = 0.537), guardians(r = 0.642) and type of temperament(r = 0.635) were correlated with compliance to functional exercises in school-age children with limb fractures (all p < 0.05). Logistic regression analysis indicated that age ≤ 10y (OR2.913, 95%CI2.091 ~ 3.611), only child of family (OR2.006, 95%CI1.683 ~ 2.558), guarded by grandparents (OR1.512, 95%CI1.201 ~ 2.118), non-easy-going temperament (OR4.127, 95%CI3.811 ~ 4.902) were the influencing factors of non-compliance to functional exercises in children with limb fracture (all p < 0.05). Conclusions School-age children have poor compliance with functional exercises after limb fractures, and there are many influencing factors. For children with those risks, health care providers should actively intervene in nursing to improve children’s exercise compliance and the rehabilitation effect.

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“…Lateral closing wedge osteotomy of the humerus is an effective treatment with a reliable outcome [106]. Alternative techniques have also been described including a step-cut osteotomy [107,108], dome osteotomy [109], distraction external fixator [110] and computer-aided osteotomies [111].…”

Section: Cubitus Varusmentioning

confidence: 99%

Overview of the contemporary management of supracondylar humeral fractures in children

Duffy¹,

Oliver²,

Gelfer

et al. 2021

Eur J Orthop Surg Traumatol

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Purpose Supracondylar fractures are common injuries accounting for approximately 15% of all fractures in children with a large body of literature on this subject. Methods This article critically appraises the available evidence to provide an overview of the treatment options including the role and timing of surgery, the geometry of wire fixation and the management of nerve and arterial injury. Conclusion Management decisions are based on a number of considerations particularly fracture stability. Closed reduction and percutaneous K-wire stabilisation are commonly recommended for an unstable displaced fracture. These techniques are however associated with the potential for iatrogenic neurological injury. Vascular injury is also rare but must be recognised and treated promptly to avoid significant permanent morbidity.

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Early correction of malunited supracondylar humerus fractures in young children

Cited by 10 publications

References 29 publications

Correction of Cubitus Varus Using Computer-Assisted Hexapod Multiplanar External Fixators

Correction of Cubitus Varus Using Computer-Assisted Hexapod Multiplanar External Fixators

Compliance of functional exercises in school-age children with limb fractures: implication for nursing countermeasures

Overview of the contemporary management of supracondylar humeral fractures in children

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