Operative management of type III extension supracondylar fractures in children

Kazımoğlu, Cemal; Çetin, Murat; Şener, Muhittin; Ağuş, Haluk; Kalanderer, Önder

doi:10.1007/s00264-008-0605-0

Cited by 60 publications

(80 citation statements)

References 17 publications

(20 reference statements)

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“…The levels of evidence of these studies were II (prospective comparative study) [2], III (retrospective comparative study) [1,7], and IV (case series) [21,26,35,39]. Two hundred and twenty-six patients were included for the final analysis.…”

Section: Methodsmentioning

confidence: 99%

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Surgical approaches for open reduction and pinning in severely displaced supracondylar humerus fractures in children: A systematic review

Mazzini

Martín

Esteban

2010

Journal of Children's Orthopaedics

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Purpose There is no clear evidence in the actual literature regarding which of the surgical approaches could bring about the best functional, cosmetic, and radiological outcomes, as well as fewer complications, when an open reduction and pinning of a severely displaced supracondylar humerus fracture is performed. We, therefore, performed a systematic review of the English literature to investigate the existing evidence regarding this issue. Methods A MEDLINE and EMBASE databases search was performed to identify articles that focused on the functional, cosmetic, and radiological outcomes, as well as post-surgical complications, regarding different surgical approaches used for open reduction and pinning in severely displaced supracondylar humerus fractures in children. One hundred and ninety-four articles were identified, of which seven were included for review. Data analysis included weighted means for all contingency tables and the Chi-square test. Standardized residues were studied when the Chi-square test was statistically significant. Statistical analyses were conducted using Stata 9.1/SE (StataCorp., College Station, TX) and P-values lower than 0.05 were considered to be statistically significant for all analyses. Results For functional outcome, a high frequency of excellent results was found within the lateral and medial approaches, and a high frequency of good results within the anterior approach. A high frequency of poor results was found within the posterior approach. For cosmetic outcome, there was a high frequency of fair results within the posterior and lateral approaches, and a high frequency of poor results within the posterior approach. No statistically significant difference regarding time to union, as well as complications, was found. Conclusion Our results suggest that a combined anteromedial approach could be the method which allows the achievement of better functional and cosmetic outcome according to Flynn's criteria. Time to union, as well as post-surgical complications, should not be an issue regarding surgical approaches used for open reduction and pinning in these fractures.

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Section: Methodsmentioning

confidence: 99%

“…Two hundred and twenty-six patients were included for the final analysis. Patients were distributed into the different surgical approaches as follows: lateral (58) [2,7,21], medial (50) [21,26,39], posterior (47) [1,21,26], anterior (65) [35,39], and medial ? lateral (6) [21,26,39].…”

Section: Methodsmentioning

confidence: 99%

Surgical approaches for open reduction and pinning in severely displaced supracondylar humerus fractures in children: A systematic review

Mazzini

Martín

Esteban

2010

Journal of Children's Orthopaedics

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“…[13,14] Under some conditions, however, such as soft tissue entrapment, severely displaced fracture, very edematous elbow, open fracture, or neurovascular injury, open reduction may be required. [5][6][7]15,16] A lateral, medial, anterior, or posterior approach can be used for open reduction. [8,17] Most surgeons prefer medial or lateral approach, [5,18] but anterior approach is also a safe and simple method.…”

Section: Discussionmentioning

confidence: 99%

The Comparison of Lateral versus Triceps Splitting Posterior Approach in the Surgical Treatment of Pediatric Supracondylar Humerus Fractures

Türkmen

Toker

Kesik

et al. 2016

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Supracondylar humerus fracture is the most common fracture of the elbow in children. Closed reduction and percutaneous pinning is considered to be the optimal treatment strategy; however, in some instances, open reduction may be necessary. The aim of this retrospective study was to compare clinical and functional results of triceps-splitting posterior versus lateral approach in pediatric supracondylar humerus fracture surgery.

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“…Classically, prompt reduction and percutaneous pinning is the method of choice. 13,16 According to the literature, neglected supracondylar humeral fractures are those who are more than 14 days old and have already started the biological process of healing with early callus formation.…”

Section: Discussionmentioning

confidence: 99%

Open Reduction and K - Wire Fixation of Very Late Presenting Paediatric Suprasupra Condylar Humeral Fractures Using Inverted v - Y Tricepsplasty Approach and Callus Osteoclasis

Singh¹,

Chaurasia²,

Lakhtakia³

2015

jemds

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BACKGROUNDFracture supracondylar humerus is a common paediatric injury. The current preferred treatment option for the displaced supracondylar fracture is early closed reduction and percutaneous pinning. Neglected displaced fractures of supracondylar humerus are not uncommon in developing countries like India. We prospectively evaluated the results of early correction of 8 malunited paediatric supracondylar humeral fractures using inverted V-Y tricepsplasty approach and callus osteoclasis (Calloclasis). MATERIAL AND METHODSThis prospective study included 10 extension type malunited paediatric supracondylar fractures that were operated from July 2012 to June 2014. Exposure of the distal humerus was done using inverted V-Y tricepsplasty approach. The entire callus tissue was circumferential removal, anatomic reduction of the displaced bony fragments was achieved and then fixation with two Kirschner wires was done. K-wires were removed at around 4 th week postoperatively and patients were followed up monthly up to the 6 months. RESULTSAll fractures united in a mean duration of 7.4 weeks. At last follow-up after 5 months on average, 7 (87.5%) patients had satisfactory outcomes. Iatrogenic ulnar neuropraxia was found in 1 patient and restricted range of motion was noted in 1 patient. CONCLUSIONThe advantages of V-Y tricepsplasty approach is that it is simple and allows doing a circumferential callus osteoclasis, which helps in reducing and fixing the fracture under direct visual control. The disadvantage of this approach is that it is associated with more postoperative pain and requires prolonged triceps rehabilitation.

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Operative management of type III extension supracondylar fractures in children

Cited by 60 publications

References 17 publications

Surgical approaches for open reduction and pinning in severely displaced supracondylar humerus fractures in children: A systematic review

Surgical approaches for open reduction and pinning in severely displaced supracondylar humerus fractures in children: A systematic review

The Comparison of Lateral versus Triceps Splitting Posterior Approach in the Surgical Treatment of Pediatric Supracondylar Humerus Fractures

Open Reduction and K - Wire Fixation of Very Late Presenting Paediatric Suprasupra Condylar Humeral Fractures Using Inverted v - Y Tricepsplasty Approach and Callus Osteoclasis

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