Supracondylar fractures of the humerus in childhood: range of movement following the posterior approach to open reduction

Sibly, T.F.; Briggs, Patrick; Gibson, Michael J.

doi:10.1016/0020-1383(91)90128-2

Cited by 60 publications

(33 citation statements)

References 10 publications

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“…The most common complication of ORIF in surgical treatment of supracondylar fracture in children is loss of elbow joint motion. This complication is usually quoted to be more prevalent in posteriorly treated children [24][25][26][27]. In this study, we could not find a significant difference between elbows motions in the posteriorly treated patients and other approaches.…”

Section: Discussioncontrasting

confidence: 65%

Surgical Outcomes of Pediatric Humeral Supracondylar Fractures Treated By Posterior Approach and Triceps Splitting

F¹

2013

J Trauma Treat

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Section: Discussioncontrasting

confidence: 65%

Surgical Outcomes of Pediatric Humeral Supracondylar Fractures Treated By Posterior Approach and Triceps Splitting

F¹

2013

J Trauma Treat

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“…Sibly et al [10] further demonstrated no correlation between stiffness and type of surgical approach used, although the posterior approach has been criticised in the past in this regard. There appeared to be no difference in our series between the different approaches used with regard to cosmetic and functional outcome.…”

Section: Discussionmentioning

confidence: 99%

Displaced supracondylar fractures of the humerus in children

Mulhall

Abuzakuk

O’Sullivan

2000

International Orthopaedics

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We performed an outcome study of completely displaced supracondylar fractures in children in order to assess the outcome of primary open reduction and internal fixation for these injuries. A total of 16 patients (mean age of 5.9 years) were included in the study. The mean follow-up was 2.6 years and patients were assessed after fracture healing using the criteria of Flynn et al. and Mark et al. Thirteen patients had an excellent result, two had good results with less than 10°loss of carrying angle and one had a fair result based on degree of loss of elbow flexion. Open reduction and internal fixation of these fractures is an effective and safe method of primary treatment and is associated with good outcomes. We recommend a low threshold of proceeding to open treatment in these serious injuries.Résumé Nous avons conduit un suivi de fractures supracondyliennes du coude chez l'enfant afin d'évaluer les effets d'une réduction ouverte primaire et d'une fixation interne sur ces lésions. Seize patients sont inclus dans cette étude, avec un age moyen de 5.9 ans. La durée moyenne du suivi fut de 2.6 ans et les patients furent examinés après consolidation, utilisant les critères de Flynn et al. et Mark et al. Treize patients présentèrent un résultat excellent, deux eurent de bons résultats avec une perte d'angle de charge inférieure de 10°, et un obtenait un résultat moyen à cause d'une perte de flexion du coude. La réduction ouverte avec la fixation interne des fractures complètement déplacé est une méthode efficace qui donne de bons résultats. Nous recommandons un passage plus fréquent aux traitements ouverts dans ces cas de lés-ions graves.

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“…Myositis may happen, but is mostly minimal and not restricting range of motion. The risk of stiffness after open surgery is not relevant except for posterior approaches [40,76,83]. The latter adds trauma to nontraumatized structures in the presence of already traumatized anterior structures [55].…”

Section: Complete Displacement (Gartland Iiia B Holmberg III Von Lmentioning

confidence: 99%

Supracondylar Fractures of the Humerus in Children

Hasler

2001

Eur J Trauma

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Closed reduction and percutaneous pinning techniques for displaced supracondylar fractures of the humerus in children (Gartland type III) have overcome disastrous ischemic complications and long inpatient treatment. Closed reduction of those highly unstable fractures and the demanding pin placement itself are potential sources of failure for the inexperienced reflected by the rate of cubitus varus which is still about 5-15% in recent series. Rotational primary and residual displacement has to be appreciated to prevent permanent cosmetic deformity. Malrotation is the major source of instability since bicolumnar support is lost which allows the distal fragment to tilt. Biomechanically tested better stability of crossed medial and lateral pins in comparison to two parallel lateral pins does not seem to be of practical importance. The risk of ulnar nerve injury by medial-pin fixation is not outweighed by significantly better clinical result. The rate of iatrogenic nerve injuries is 3-16% with the ulnar nerve being the most susceptible due to inadvertent pinning. Despite a high recovery rate, they are a nuisance for the patients. Fracture-related peripheral neuropathies have an incidence of 10-17%. With rare exceptions, concomitant nerve lesion recover spontaneously within a time range of 1-4 months. There is still controversy regarding the management of a post reduction pink, warm but pulseless hand with adequate capillary refill. Simple observation and conservative management lead to a favorable clinical outcome in most cases but cold intolerance or exercise-induced ischemic symptoms are a potential sequel.

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Supracondylar fractures of the humerus in childhood: range of movement following the posterior approach to open reduction

Cited by 60 publications

References 10 publications

Surgical Outcomes of Pediatric Humeral Supracondylar Fractures Treated By Posterior Approach and Triceps Splitting

Surgical Outcomes of Pediatric Humeral Supracondylar Fractures Treated By Posterior Approach and Triceps Splitting

Displaced supracondylar fractures of the humerus in children

Supracondylar Fractures of the Humerus in Children

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