Fractures in the Elbow Region

Wilkins, Kaye E.

doi:10.1016/b978-1-4160-2957-1.10032-6

Cited by 106 publications

(194 citation statements)

References 14 publications

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“…Thus, the incidence of exposed fractures that was found (71%) was much higher than among cases of single fractures. In a meta-analysis on 61 studies reporting on a total of 7,212 supracondylar fractures of the humerus, Wilkins (13) found that the incidence of exposed fractures was just 1%.…”

Section: Discussionmentioning

confidence: 99%

“…Although conservative treatment has been cited in the literature (7,8) , most authors agree that surgical treatment is essential (2,6,12,13) . Traction does not allow anatomical reduction, and placement of a plaster cast with the arm flexed (which would be necessary to provide greater stability to supracondylar fractures) is contraindicated because of the severe edema that is present, which would increase the risk of compartment syndrome.…”

Section: Discussionmentioning

confidence: 99%

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Cotovelo flutuante em crianças: estudo descritivo de 31 casos atendidos em centro de referência em traumatologia pediátrica

Malheiros¹,

Bárbara²,

Mafalda³

et al. 2011

Rev. bras. ortop.

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Objective: To conduct a descriptive analysis on 31 cases of children with floating elbow who were attended at our clinic between 1994 and 2009, and to review the literature relating to this topic. Methods: Data were obtained through examining the medical records. The following variables were used: age, gender, side, mechanism, type of fracture, classification, treatment and complications. Results: Twentyfour patients (77.4%) were male and seven (22.6%) were female. The mean age was 8.5 (± 3.2) years, ranging from one to 14 years. The left side was predominantly affected (67.7%). The commonest injury mechanism was a fall from a height (74.2%). All the supracondylar fractures were Gartland type III. Distal radius fractures alone, of SalterHarris type II, were diagnosed in 22 patients (71%). Open fractures occurred in 22 cases (71%). Closed reduction and application of a plaster cast for a closed fracture of the distal radius was performed in two patients (6.45%). Simultaneous conservative treatment for two fractures was not used. Sixteen supracondylar fractures (54.8%) were fixed using crossed wires, at 90° to each other, and in 14 cases (45.16%), an intramedullary wire was used together with another wire introduced through the lateral epicondyle at 45°. The following complications were observed: deformed consolidation (10%), nerve injuries (6%), compartment syndrome (3%) and pin path infection (16%). Conclusions: This is an uncommon injury that in most cases results from high-energy trauma. Surgical treatment for both fractures is recommended by most authors. Ulnar nerve injuries were correlated with the fixation method, but no neurological injuries were triggered by the initial trauma.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cotovelo flutuante em crianças: estudo descritivo de 31 casos atendidos em centro de referência em traumatologia pediátrica

Malheiros¹,

Bárbara²,

Mafalda³

et al. 2011

Rev. bras. ortop.

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“…Wilkins [22] modified the Gartland classification to make it more clinically relevant, including the concept of posterior humeral cortical contact. Extension type I injuries were nondisplaced; type II injuries were displaced anteriorly (anterior humeral line anterior to capitellum [ Fig.…”

Section: Description Of the Gartland Classificationmentioning

confidence: 99%

“…Wilkins also subdivided type II injuries into IIA and IIB categories: IIA fractures have no rotational abnormality or fragment translation, and IIB injuries do, resulting in more instability [22]. In 1995, De Boeck et al [10] described a subtype of supracondylar humerus fracture where the medial column of the humerus is comminuted and unstable, leading to loss of Baumann's angle (Fig.…”

Section: Volume 473 Number 2 February 2015mentioning

confidence: 99%

“…Barton et al [4] evaluated the reliability of the modified Gartland classification, using a version modified by Wilkins et al in 1996 [23], which included three types of fracture based on the amount of displacement and posterior cortical hinge. Type IV and the medial column comminution subtypes had not yet been added at the time of their work.…”

Section: Reliabilitymentioning

confidence: 99%

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Classifications In Brief: The Gartland Classification of Supracondylar Humerus Fractures

Alton

Werner

Gee

2015

Clinical Orthopaedics &Amp; Related Research

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Upper limb nerve injuries in developmental age

Senes¹,

Campus²,

Becchetti³

et al. 2009

Microsurgery

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Our series includes 105 children with peripheral nerve injuries of the upper limb due to trauma. The aim of this study is to validate our therapeutic approach to peripheral nerve injuries of the upper limb in children and to identify the suitable waiting time before surgical exploration. Case series examination included evaluation of (1) type of lesion; (2) topographical site of nerve injury; (3) motor and sensory outcome; (4) recovery time; (5) results after surgery. Open injuries (Sunderland V) received immediate treatment with direct suturing or nerve grafts or biological tubules in case of loss of nerve substance. After closed nerve injury, a waiting period of variable duration should precede surgery. Most of the cases had peripheral nerve injuries associated to fracture and cutting lesions followed by injuries due to other causes. Open or closed injuries of the median and radial nerves had a generally favorable prognosis, whereas ulnar nerve injuries (both isolated and associated) had a poor prognosis. Stable skeletal fixation is essential in fractures at risk of nerve involvement. During nerve exploration, secondary surgery interventions were never associated. In the absence of adequate clinical and instrumental response, the authors suggest to resort to nerve surgery at 6 months from injury to accelerate recovery time. Secondary surgery should be delayed as patient's recovery time can be very long. (c) 2009 Wiley-Liss, Inc. Microsurgery, 2009.

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Fractures in the Elbow Region

Cited by 106 publications

References 14 publications

Cotovelo flutuante em crianças: estudo descritivo de 31 casos atendidos em centro de referência em traumatologia pediátrica

Cotovelo flutuante em crianças: estudo descritivo de 31 casos atendidos em centro de referência em traumatologia pediátrica

Classifications In Brief: The Gartland Classification of Supracondylar Humerus Fractures

Upper limb nerve injuries in developmental age

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