Factors influencing the complication rate in pediatric supracondylar humerus fractures

Körner, Daniel; Laux, Florian; Stöckle, Ulrich; Gonser, Christoph

doi:10.4081/or.2019.7949

Cited by 3 publications

(3 citation statements)

References 22 publications

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“…16 Management of these fractures in children is associated with a big challenge related to patient factors, fracture-related factors, and treatment-related factors, and any of these can contribute to a high complication rate and unsatisfactory outcome. 17 This study, therefore, sought to describe the functional and radiological outcome of SCF of the humerus and their associated factors in children managed at Mulago National Referral Hospital.…”

Section: Introductionmentioning

confidence: 99%

Short-Term Management Outcomes of Supracondylar Fractures of the Humerus and Their Associated Factors in Children Managed at Mulago National Referral Hospital

Sheikdon¹,

Mulepo²,

Waiswa³

et al. 2022

ORR

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Purpose Supracondylar fractures (SCF) of the humerus is one of the commonest global health concerns among children and need a rigorous management process to obtain satisfactory outcomes. It is of paramount importance to use systematic guidelines to aid abate bad fracture outcomes. The study primarily sought to determine the functional and radiological management outcomes of SCF of the humerus in children at Mulago National Referral Hospital (MNRH) and associated factors to the outcomes. Methods We conducted a hospital-based, cross-sectional study among children managed for SCF of the humerus at MNRH. Using Flynn’s criteria, current flexion and extension at the elbow joints, humeroulnar angle and the neurology were assessed and compared to the contralateral limb to get the functional outcomes. The pre-management digital radiographs of the elbow joint were compared with the current radiographs to assess radiological outcomes. Bivariate and multivariate analyses were used to determine the associated factors. Results Of the 77 children, 46 (60%) were male with a mean age of 7.86±2.30 years. Gartland type I fracture constituted 55.8% (43), type II was 29.9% (23) and type III was 14.3% (11). About 88.3% of the patients were managed non-operatively and 11.7% were managed operatively. The overall satisfactory functional outcome was 46.7%, while 81.8% of the patients had a satisfactory radiological outcome at 6 months after the intervention. Delay in seeking treatment, type 1 fracture, and prolonged duration of immobilization were significantly associated with unsatisfactory functional management outcome. Type II fracture and prolonged duration of immobilization were significantly associated with unsatisfactory radiological management of SCF of the humerus. Conclusion The short-term functional outcome was unsatisfactory, while a satisfactory radiological outcome was found in most of the patients. Duration of immobilization, type of fracture, and seeking late medical care had a negative impact on the outcome of these fractures.

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Section: Introductionmentioning

confidence: 99%

Short-Term Management Outcomes of Supracondylar Fractures of the Humerus and Their Associated Factors in Children Managed at Mulago National Referral Hospital

Sheikdon¹,

Mulepo²,

Waiswa³

et al. 2022

ORR

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“…Although loss of reduction occurred more frequently among type III fractures than type II, there was not a significant difference in the incidence of changes in management based on fracture type. However, other studies have shown that there is an increased incidence of complications among higher grade fractures [16]. Moreover, in an analysis of 572 patients, Karalius et al .…”

Section: Discussionmentioning

confidence: 99%

Radiographic considerations for pediatric supracondylar humerus fractures

Flood

Bauer

Sullivan

2022

Journal of Pediatric Orthopaedics B

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Although supracondylar humerus fractures are common pediatric injuries, guidelines for postoperative imaging remain unclear. This study's purpose was to evaluate decision-making at various points in the postoperative period. The secondary objective was to compare the use of mini C arm fluoroscopy and flat plate X-rays at the first postoperative visit. A retrospective, cohort study was performed at one level I trauma center. Patients ages 1 to 14 with extension Gartland type II-IV supracondylar fractures sustained between January 2013 and May 2020 and treated with closed or open reduction and percutaneous fixation were included. Data collected included demographics, fracture characteristics, and imaging information. Of 553 patients who underwent surgery, 375 (67.8%) received intraoperative images after casting; none resulted in an intraoperative intervention. Of 463 patients with imaging at first follow-up, nine (1.9%) had a management modification, including seven for loss of reduction, all determined by the original operating surgeon. The method of imaging, did not differ significantly with respect to revision surgery. Twentysix (4.0%) of 532 patients with imaging at pin removal received additional casting after pin removal, but no patients had their pins retained. This retrospective study examined the efficacy of imaging in pediatric supracondylar fractures. Intraoperative, postcasting images did not change management and should be discontinued. Imaging at first follow-up can be useful in identifying patients with loss of reduction and mini C arm serves as a viable alternative to standard X-rays. Finally, imaging at pin removal resulted in additional casting only in type III fractures. Level of evidence: Level III-retrospective, cohort study.

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“…Komplikacijos. 2019 metais Vokietijoje atliktame tyrime nustatyta, jog III tipo pagal Gartland lūžis ir operacinė gydymo taktika buvo pagrindiniai veiksniai, padidinę komplikacijų (amplitudės sumažėjimas, nervų -kraujagyslių pažeidimas) skaičių [23].…”

Section: Tipas II Tipas Iii Tipas Nedislokuotas Lūžis Iš Dalies Dislo...unclassified

Perkutaninės Osteosintezės Metodų Taikymas Vaikų Žastikaulio Viršgumburinių Lūžių Gydymui

Inkėnas,

Čekanauskas

2022

Health Sciences

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Viršgumburinio žastikaulio lūžio mechanizmas susijęs su vaiko amžiumi, todėl ši priklausomybė plačiai tiriama ir interpretuojama. Distalinės žastikaulio žievės suplonėjimas bei alkūninės duobės ir alkūninės ataugos sąveika – tai priežastys, kurios nulemia jaunesniojo amžiaus vaikų pažeidžiamumą. Teigiama, kad lūžio tipas pagal Gartland klasifikaciją ir operacinė gydymo taktika buvo pagrindiniai veiksniai, nulemiantys komplikacijų skaičių. Mokslininkai nustatė, kad dislokuotiems II ir III tipo lūžiams rekomenduojamas gydymas yra perkutaninė osteosintezė. Taikomi keletas suprakondilinių lūžių (dažniausiai Gartland II ir III lūžio tipo) perkutaninės osteosintezės būdų. Modifikuotas Dorgan metodas jungia kryžminės perkutaninės osteosintezės Kiršnerio strypais ir Dorgan metodų privalumus, t.y. kryžminio vėrimo mechaninis stabilumas, atlikimo paprastumas ir Dorgan metodikos saugumas. Straipsnyje apžvelgiama vaikų viršgumburinio žastikaulio lūžių epidemiologija, traumos mechanizmas, diagnostika, gydymo parinkimo taktika, išryškinamos komplikacijos ir gydymo baigtis, priklausomai nuo lūžio tipo pagal Gartland klasifikaciją.

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Factors influencing the complication rate in pediatric supracondylar humerus fractures

Cited by 3 publications

References 22 publications

Short-Term Management Outcomes of Supracondylar Fractures of the Humerus and Their Associated Factors in Children Managed at Mulago National Referral Hospital

Short-Term Management Outcomes of Supracondylar Fractures of the Humerus and Their Associated Factors in Children Managed at Mulago National Referral Hospital

Radiographic considerations for pediatric supracondylar humerus fractures

Perkutaninės Osteosintezės Metodų Taikymas Vaikų Žastikaulio Viršgumburinių Lūžių Gydymui

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