Supracondylar fracture of the humerus in children.

PALMER, ERICH; Niemann, Kurt M. W.; Veselý, David; Armstrong, J H

doi:10.2106/00004623-197860050-00011

Cited by 66 publications

(26 citation statements)

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“…The lower segment fractures may be also at different locations: olecranon, radial neck, Monteggia lesions, and various levels of the bone shaft and distal forearm [19,20,11]. Palmer et al in their analysis of 78 supracondylar fractures found four ipsilateral fractures of the radius and ulna, two ipsilateral fractures of the radius alone and one ipsilateral midshaft ulna fracture [21]. Stanitski coined the term floating elbow for such injury, considered a high energy fracture [7,20].…”

Section: Discussionmentioning

confidence: 99%

Ipsilateral fracture of the supracondylar humerus and forearm in children

Hussain¹

2014

IJCRI

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International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations.IJCRI publishes Review Articles, Case Series, Case Reports, Case in Images, Clinical Images and Letters to Editor. Website: www.ijcasereportsandimages.comIpsilateral fracture of the supracondylar humerus and forearm in children Shahid Hussain ABSTRACT Introduction: Simultaneous ipsilateral fracture of the elbow and forearm (floating elbow) is an uncommon injury and treatment recommendations are controversial. The aim of our study was to evaluate the incidence of ipsilateral fractures of the upper limb and to present our experience in dealing with such injuries and to review the literature relating to this topic. The following variables were used: age, gender, side, mechanism of injury, type of fracture, classification, treatment methods, complications and outcome. Case Series: We prospectively followed five children who presented with displaced supracondylar fractures of the humerus associated with a forearm fracture of the same limb. All patients underwent emergency procedures in the form of closed reduction and K-wire fixation/ cast fixation. At a minimum follow up of 24 months, all patients were assessed clinically and radiologically and the results evaluated according to a conventional scoring system. Four patients had excellent or good outcomes, and there was one poor result. Conclusion:The floating elbow is an indicator of a high energy injury. The incidence of open fractures, compartment syndrome and nerve injury and the need to perform an open reduction were higher than those recorded for isolated supracondylar or forearm fractures. The existing controversies in the management of such a complex injury and associated problems are outlined. A pertinent literature review is also included.

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Section: Discussionmentioning

confidence: 99%

Ipsilateral fracture of the supracondylar humerus and forearm in children

Hussain¹

2014

IJCRI

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“…Other authors applied the traction with the elbow slightly flexed. 12 Skeletal traction with a K-wire 13 or a screw anchor 14 have also been reported. Management of the fracture by straight-arm traction seems to have become less popular, even to have fallen into disrepute.…”

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confidence: 99%

Elevated, straight-arm traction for supracondylar fractures of the humerus in children

Gadgil

Hayhurst

Maffulli

et al. 2005

The Journal of Bone and Joint Surgery. British volume

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, 112 children with a closed displaced supracondylar fracture of the humerus without vascular deficit, were managed by elevated, straight-arm traction for a mean of 22 days. The final outcome was assessed using clinical (flexion-extension arc, carrying angle and residual rotational deformity) and radiographic (metaphyseal-diaphyseal angle and humerocapitellar angle) criteria. Excellent results were achieved in 71 (63%) patients, 33 (29%) had good results, 5 (4.4%) fair, and 3 (2.6%) poor. All patients with fair or poor outcomes were older than ten years of age.Elevated, straight-arm traction is safe and effective in children younger than ten years. It can be effectively used in an environment that can provide ordinary paediatric medical care and general orthopaedic expertise. The outcomes compare with supracondylar fractures treated surgically in specialist centres.No single method of management is suitable for all supracondylar fractures of the humerus in children.

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“…The obvious difference between the two treatments is seen in the duration of the hospital stay. This was a median of 11 days (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16) for the children treated with skeletal traction, 2 days (1-31) in the closed reduction pin fixation group and in the open reduction group, it was 2 days (range 2-6). The markedly shorter hospital stay for children treated with crossed wire fixation is, of course, of great benefit to the patient and the family and reduces the cost of treatment.…”

Section: Discussionmentioning

confidence: 99%

“…This reduced the rate of serious complications significantly [8], but still resulted in up to 33% cubitus varus deformity [9]. Skeletal traction with a K-wire [5,10] or a screw [11] in the olecranon was later shown to give better control of the fracture reduction. In 1939, Miller described ''blind nailing'' of distal humeral fractures in adults [12] and in 1948, Swenson suggested percutaneous crossed pin fixation for SCHF in children [13].…”

Section: Introductionmentioning

confidence: 99%

Deformity and functional outcome after treatment for supracondylar humerus fractures in children: A 5- to 10-year follow-up of 139 supracondylar humerus fractures treated by plaster cast, skeletal traction or crossed wire fixation

Young

Fevang

Gullaksen

et al. 2010

Journal of Children's Orthopaedics

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The introduction of crossed wire fixation has significantly reduced the number of days for which patients are hospitalised for SCHF. The rate of nerve injuries in Gartland type 3 fractures is high. Despite the fact that this study includes the first patients to be treated with crossed wire fixation at our institution, no significant increase in the risk of complications could be found compared to skeletal traction.

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Supracondylar fracture of the humerus in children.

Cited by 66 publications

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Ipsilateral fracture of the supracondylar humerus and forearm in children

Ipsilateral fracture of the supracondylar humerus and forearm in children

Elevated, straight-arm traction for supracondylar fractures of the humerus in children

Deformity and functional outcome after treatment for supracondylar humerus fractures in children: A 5- to 10-year follow-up of 139 supracondylar humerus fractures treated by plaster cast, skeletal traction or crossed wire fixation

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