Supracondylar Fractures

In this prospective case series we evaluated the effectiveness and safety of using an anterior approach to paediatric supracondylar humerus fractures. We gathered data on 46 children that had a displaced supracondylar fracture of the humerus. All the patients had sustained a Gartland type III extension fracture that could not be reduced by closed means. Open reduction through an anterior approach was performed and two Kirschner wires were used to fix the fracture to the medial and lateral sides. Patients were recalled for follow-up and were evaluated using Flynn's radiological and clinical criteria. Loss of extension and flexion was noted by clinical assessment and carrying angle measured on radiograms. A follow-up examination performed in the 24th postoperative week showed that all fractures had healed; the patients' outcomes were rated as excellent or good according to Flynn's criteria. As a result the anterior approach for open reduction of paediatric supracondylar humeral fractures is a safe and reliable method with very good results.

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“…Closed reduction and percutaneous pinning has been accepted as the gold standard in reaching these goals by many authors [5,7,9,11,12,16].…”

Section: Discussionmentioning

confidence: 99%

Treatment of supracondylar fractures of the humerus in children through an anterior approach is a safe and effective method

Ersan

Gönen

Arık

et al. 2008

International Orthopaedics (SICOT)

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“…Essa deformidade decorre principalmente de uma má redução inicial ou uma perda da redução no decorrer do tratamento (14)(15)(16)(17)(18)(19)(20)(21) .…”

Section: Introductionunclassified

Desvios rotacionais na fratura supracondiliana do úmero em crianças: novo método de avaliação

Filho¹,

Veloso²,

Akkari³

et al. 2011

Rev. bras. ortop.

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RESUMOObjetivo: Descrever um novo método para identificar e quantificar os desvios rotacionais da fratura supracondiliana do úmero. Métodos: O estudo foi realizado usando modelos sintéticos de úmero, serrando-o perpendicular ao seu longo eixo, na região da fossa olecraniana, fixando-o com diferentes desvios rotacionais, e então uma radiografia das peças foi obtida. Foi realizada uma análise descritiva da sensibilidade e especificidade do método de visualização do "esporão metafisário" com o teste não paramétrico de Kruskal-Wallis. A análise de regressão linear foi utilizada para identificar uma relação entre tamanho do esporão e o grau de desvio rotacional da fratura. Resultados: A sensibilidade e a especificidade do método foram de 100% a partir de 15 graus de desvio rotacional e houve uma relação estatisticamente significante entre o tamanho do esporão e o grau do desvio rotacional. Conclusão: O método demonstrou ser de fácil aplicação, confiável e reprodutível neste trabalho. Descritores - INTRODUÇÃOAs fraturas do cotovelo correspondem cinco a 10% de todas as fraturas nas crianças (1) . Dentre estas, as fraturas supracondilianas do úmero são responsáveis por até 50 a 70% dos casos (2)(3)(4) , acometendo principalmente crianças na faixa etária entre cinco e sete anos de idade (5) . As lesões ocorrem predominantemente à esquerda, ou do lado não dominante (5-7) .O mecanismo de trauma mais comum é a queda com apoio do membro superior e o cotovelo em extensão completa, levando o olécrano a realizar um fulcro posterior na sua fossa, região de maior fragilidade, provocando uma fratura do tipo em extensão, isto é, com desvio posterior (8,9) . Este tipo de desvio representa cerca de 97% a 99% dos casos (5,8) .Vários métodos de tratamento têm sido descritos,Rev Bras Ortop. 2011;46(Suppl 4):45-50

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“…Most deformity seems to be related to coronal plane angulations [1]. It should also be appreciated that rotation of the distal fragment often worsens varus and valgus angulations [2]. The deformity results from two factors: primary mal-reduction of the fracture and the limited remodelling in the coronal plane [3].…”

Section: Backgroundsmentioning

confidence: 99%

Preliminary view on new roentgenologic trochleocapitellar index for assessment accuracy of the reduction supracondylar fracture of the elbow in children to comparison Baumann's angle

Gorelick¹,

Gelman²,

Rozano-Gorelick³

et al. 2015

J Rheumatol Orthop

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BackgroundsAngulations deformity (cubitus varus and valgus) is the most common complication of displaced supracondylar fractures. Most deformity seems to be related to coronal plane angulations [1]. It should also be appreciated that rotation of the distal fragment often worsens varus and valgus angulations [2]. The deformity results from two factors: primary mal-reduction of the fracture and the limited remodelling in the coronal plane [3]. Prevention of angulations depends on the accurate reduction of the fracture. The gold standard in clinical practice, today, is an assessment of reduction quality using Baumann's angle. Baumann's angle formed by the intersection of a line drawn down the humeral axis and a line drawn along the growth plate of the capitellum of the elbow [4]. This angle correlates closely with the carrying angle [5]. The mean Baumann's angle is 72°±4°. The new TCI of the elbow is the ratio between the smaller trochlear and larger capitellar angles of the measured elbow (Figure 1). The rationale is that an index based on the AbstractBackground: In children supracondylar fracture of the humorous is one of the most common fractures in the first decade of life. This study was conducted to establish the efficacy and the accuracy of a new own method for measuring the Trochleocapitellar index (TCI) in the management of supracondylar humeral fracture in children versus Baumann's angle. Methods: This study made on base AP elbow radiograms and clinical charts of 54 children that were treated due to supracondylar fracture of the elbow. Cases included were of either gender with age range from four to 13 years with a supracondylar fracture presenting within 72 hours of the reduction. Outcome measures: Two measure roentgen logic modalities studied for comparison: Baumann's angle and TCI were taken into consideration when examining the AP roentgenograms (immediately after the reduction and during 1-3 months thereafter). Results: During 1-3 months after the reduction Baumann's angle modality gave normal results in 51 (94.4%), valgus result in one (1.9%) and varus result in two (3.7%) patients. While TCI showed normal results in 31 (57.4%), valgus result in one (1.9%) and varus results in 22 (40.7%) patients. Correlation was found between the measurements of the normal Baumann's angle and normal TCI immediately after fracture reduction (r=0.75, p<0.001) and on the period between one to three months follow-up (r=0.54, p<0.001). TCI was found as more accurate for detection of cubitus varus. Conclusions: Authors recommends post reduction measurement of the TCI in supracondylar fractures to determine the adequacy of reduction.

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Supracondylar Fractures

Cited by 93 publications

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Treatment of supracondylar fractures of the humerus in children through an anterior approach is a safe and effective method

Treatment of supracondylar fractures of the humerus in children through an anterior approach is a safe and effective method

Desvios rotacionais na fratura supracondiliana do úmero em crianças: novo método de avaliação

Preliminary view on new roentgenologic trochleocapitellar index for assessment accuracy of the reduction supracondylar fracture of the elbow in children to comparison Baumann's angle

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