Recovery of Elbow Motion Following Pediatric Lateral Condylar Fractures of the Humerus

Bernthal, Nicholas M.; Hoshino, C Max; Dichter, Daniel H.; Wong, Melissa; Silva, Maurício

doi:10.2106/jbjs.j.00935

Cited by 57 publications

(45 citation statements)

References 11 publications

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“…Loss of ROM after treatment of pediatric supracondylar humeral fracture is often a concern of parents. It seemed that open reduction, complication of myositis ossificans, older age, longer period of immobilization and more severe injury type would increase the incidence of limited ROM or prolong the recovery in elbow motion [ 20 , 21 ]. Free fracture fragment near the joint is always associated with poor functional outcomes in joint or periarticular fractures [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

The outcome of loose bone fragments in pediatric supracondylar humerus fractures: a retrospective study

Yang

et al. 2020

Journal of Pediatric Orthopaedics B

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We evaluated the clinical and imaging outcomes of loose bone fragments in children with supracondylar humerus fractures after closed reduction with percutaneous pin (CRPP) fixation. A retrospective review was conducted on 12 children with fragments on imaging after closed reduction of displaced humeral supracondylar fractures (Gartland III). Primary radiographic assessment included fragment outcome, postoperative Baumann angle, carrying angle and loss of reduction. Clinical outcome included the elbow range of motion (ROM), Flynn grade and other complications. Between January 2015 and January 2018, 460 children (2–14 years old) with supracondylar humerus fractures were treated at our center, including 12 (2.6%) with loose bone fragments on postoperative X-ray. Union or absorption of fragments was noted in all 12 patients at 1 year postoperatively, with good radiographic and clinical outcomes. The mean Baumann angle was 15.5° ± 4.3° and the mean carrying angle was 11.2° ± 2.8°. All patients had a normal elbow ROM. Ten patients achieved an excellent and two a good result according to the Flynn criteria. Good results were achieved after CRPP fixation in 12 children with supracondylar humerus fractures and loose bone fragments. The fragments were mainly absorbed or achieved union to the humerus within 1 year.

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Section: Discussionmentioning

confidence: 99%

The outcome of loose bone fragments in pediatric supracondylar humerus fractures: a retrospective study

Yang

et al. 2020

Journal of Pediatric Orthopaedics B

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“…This recovery is slower if the patient is older, has a longer healing time, and has a more severe injury. [ 20 ]…”

Section: Discussionmentioning

confidence: 99%

Epidemiologic features and management of elbow dislocation with associated fracture in pediatric population

Liu

Yan²,

Lu³

et al. 2017

Medicine

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This study was conducted to explore epidemiologic features of traumatic elbow dislocation with associated fractures in pediatric population following appropriate treatment options.Incidence of elbow dislocation with associated fractures was analyzed in 67 children using elbow radiographs. Treatment for the displaced elbow joint was performed by closed reduction and proper immobilization. Surgical intervention was applied to restore the correct alignment of the fracture. Mayo Elbow Performance Score (MEPS) was used to measure elbow joint function.Incidence of pure dislocation was observed in 7 of 67 children (10.45%). Elbow dislocation was typically accompanied by a single or multiple fractures in 39 (58.21%) and 21 (31.34%) of 67 children, respectively. In contrast, lateral humeral condyle fracture and medial humeral epicondyle fracture accounted for 35.90% and 30.77% of pediatric elbow fractures. All children with elbow fracture-dislocations received surgical intervention by open reduction and internal fixation. During follow-up, 56% to 92% of children displayed significant recovery of elbow function with improving MEPS after the displaced elbow and fractured fragments were reduced and held in place for weeks. There were statistical differences in MEPS between the types of fractures (P < .05 or P < .01).Incidence of isolated elbow dislocation without fracture is low; rather, it is frequently associated with fractures. Early surgical intervention achieves stable fixation and bony union with utility in improving elbow function in the pediatric population.

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“…Fractures were treated based on the amount of displacement, per the protocol implemented at our institution. 5 Fracture displacement was measured from the lateral metaphyseal cortex of the distal part of the humerus to the lateral cortex of the fracture fragment on the anteroposterior and oblique views and along the posterior cortex on the lateral radiograph, using the method described by Song et al 6 The greatest displacement on any single view was documented as the displacement of the fragment.…”

Section: Methodsmentioning

confidence: 99%

Closed Reduction and Percutaneous Pinning of Displaced Pediatric Lateral Condyle Fractures of the Humerus

Silva

Cooper

2015

Journal of Pediatric Orthopaedics

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Recovery of Elbow Motion Following Pediatric Lateral Condylar Fractures of the Humerus

Cited by 57 publications

References 11 publications

The outcome of loose bone fragments in pediatric supracondylar humerus fractures: a retrospective study

The outcome of loose bone fragments in pediatric supracondylar humerus fractures: a retrospective study

Epidemiologic features and management of elbow dislocation with associated fracture in pediatric population

Closed Reduction and Percutaneous Pinning of Displaced Pediatric Lateral Condyle Fractures of the Humerus

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