Evaluation of anterior approach in failed closed reduction and delayed presentation of supracondylar humerus fractures in children

Das, Rajdeep; Borthakur, Bipul; Agarwala, Vikash; Ghosh, Sujit Kumar

doi:10.1016/j.jor.2022.02.006

Cited by 5 publications

(2 citation statements)

References 51 publications

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“…Lin et al updated the technique by using mosquito forceps instead of a blunt pin, which could dissect the soft tissues more easily and lower the damage to neurovascular bundles 13 . The following literature gave good clinical and radiological outcomes, which showed that minimally invasive percutaneous leverage reduction could be a safe alternative in the treatment of humeral supracondylar fracture [28][29][30] . However, no literature reported this technique on the reduction of pediatric flexion-type SHF.…”

Section: Discussionmentioning

confidence: 94%

Minimally invasive technique combined with external fixator in the treatment of pediatric flexion-type humeral supracondylar fractures

Zhu,

Feng,

et al. 2023

Sci Rep

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Flexion-type pediatric humeral supracondylar fractures are rare, and the reduction technique remains contradictory. A minimally invasive technique using percutaneous leverage reduction combined with an external fixator was described to achieve satisfactory reduction and avoid the open reduction in this study. The operation and clinical results of patients treated with this technique were retrospectively compared with traditional closed reduction. From January 2013 to January 2018, children diagnosed with displaced flexion-type humeral supracondylar fractures were included in this study. Patients were treated with closed reduction (Group A) or minimally invasive reduction technique (Group B). The external fixator fixation was then applied. The demographic information, as well as the clinical and functional results of the operation, were retrospectively reviewed and evaluated. There were twenty-two patients, ten in Group A and twelve in Group B. The mean duration of the operation in Group A was more prolonged than Group B (59 min versus 46 min, p < 0.001). No infection, nonunion, myositis ossificans, neurovascular injury or other complications related to the operation were observed by the time the fractures healed. During an average 36 months follow-up time, almost all children achieved good to excellent results except for one fair in Group A according to the MEPS and the Flynn criteria. This study introduced a safe and efficient minimally invasive technique for displaced flexion-type supracondylar humerus fractures. With the assistance of mosquito forceps, this leverage technique might achieve similar satisfactory clinical outcomes as traditional closed reduction but with a shorter surgical duration.

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Section: Discussionmentioning

confidence: 94%

Minimally invasive technique combined with external fixator in the treatment of pediatric flexion-type humeral supracondylar fractures

Zhu,

Feng,

et al. 2023

Sci Rep

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“…Displaced supracondylar fractures had been traditionally treated as surgical emergencies for the reason that delayed surgery often required open reduction rather than closed reduction ( 20 ). In the case of delayed presentation, especially for Gartland type III fractures which is a statistically significant independent risk factor for closed reduction failure, the probability of fracture swelling is significantly increased, for which open reduction is needed to achieve better outcomes and avoid complications such as iatrogenic neurovascular injuries, stiffness, delayed union, malunion and nonunion ( 14 , 15 , 21 , 22 ). A meta-analysis conducted by Farrow L et al showed that there was no statistically significant difference in the risk of complications between immediate and 91-h delayed treatment for patients with SHFs undergoing open reduction ( 23 ).…”

Section: Discussionmentioning

confidence: 99%

Small incision reduction and external fixation for the treatment of delayed over fourteen days supracondylar humeral fractures in children

Liu

Peng²,

Liu³

et al. 2022

Front. Pediatr.

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BackgroundSupracondylar humeral fractures (SHF) are the most common type of fracture occurring at the distal humerus in children. In patients with delayed presentation of SHF, closed reduction is challenging to achieve with traditional reduction maneuvers. This study aimed to report the clinical results of pediatric SHF delayed over 14 days treated by closed reduction with a minimally invasive technique and external fixation and evaluate the efficacy of this technique.MethodsBetween October 2010 and September 2018, children with delayed presentation of SHF over 14 days were retrospectively included in this study. The patients received closed reduction with a minimally invasive technique followed by external fixation. The demographics and radiographic data were collected. The Mayo Elbow Performance Score (MEPS) and the Flynn criteria were used to evaluate the clinical outcomes of treatments.ResultsA total of 11 children (aged 4–13 years) with delayed presentation (range, 14–22 days) were recruited. They received surgery using closed reduction with a minimally invasive technique followed by external fixation. None of the surgery was done with the open method. After surgery, the patients' carrying angle returned to normal. The radiological union was evident in 8 to 12 weeks in all fractures without complications. Every patient had a good to excellent score on the MEPS and the Flynn criteria.ConclusionsThe results of this series indicated a satisfactory outcome in children with delayed more than 14 days of supracondylar humeral fractures. The closed reduction with a minimally invasive technique followed by external fixation is an alternative treatment for such injury.

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Anterior approach versus posterior approach for the open reduction of displaced pediatric supracondylar humerus fracture

Gerami,

Naderian,

Nemati

et al. 2023

Journal of Orthopaedics

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Evaluation of anterior approach in failed closed reduction and delayed presentation of supracondylar humerus fractures in children

Cited by 5 publications

References 51 publications

Minimally invasive technique combined with external fixator in the treatment of pediatric flexion-type humeral supracondylar fractures

Minimally invasive technique combined with external fixator in the treatment of pediatric flexion-type humeral supracondylar fractures

Small incision reduction and external fixation for the treatment of delayed over fourteen days supracondylar humeral fractures in children

Anterior approach versus posterior approach for the open reduction of displaced pediatric supracondylar humerus fracture

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