Supracondylar Fractures of the Humerus Associated With Ipsilateral Forearm Fractures in Children: A Report of Forty-seven Cases

Roposch, Andreas; Reis, Mark; Molina, Manuel; Davids, Jon R.; Stanley, Earl A.; Wilkins, Kaye E.; Chambers, Henry G.

doi:10.1097/01241398-200105000-00009

Cited by 32 publications

(40 citation statements)

References 20 publications

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“…While majority of isolated displaced supracondylar fractures of the humerus are managed with closed reduction and percutaneous fixation, the treatment of a supracondylar fracture in the presence of an ipsilateral forearm fracture is still controversial [7,12,14,15,25]. Though good results have been reported after conservative treatment [15,16] many authors consider pinning of the supracondylar fracture the best choice [5,13,20]. Others recommend percutaneous pinning of both proximal and distal fractures [11].…”

Section: Discussionmentioning

confidence: 99%

“…In 1960s, closed reduction and casting was recommended but an increased frequency of cubitus varus, of up to 25% of cases was observed [5,14]. Reed in an early series (15 cases) treated all of his patients by conservative methods [5,19]. Fowles (n=175) reported six cases of this injury, all of them were managed by pinning of the supracondylar fracture and closed reduction and cast immobilization of the forearm fracture [27].…”

Section: Discussionmentioning

confidence: 99%

“…Others recommend percutaneous pinning of both proximal and distal fractures [11]. In 1960s, closed reduction and casting was recommended but an increased frequency of cubitus varus, of up to 25% of cases was observed [5,14]. Reed in an early series (15 cases) treated all of his patients by conservative methods [5,19].…”

Section: Discussionmentioning

confidence: 99%

“…Various combinations of treatment options has been suggested for this injury such as primary closed reduction of both fractures and long arm cast application or olecranon pin traction till swelling subsides and delayed long arm cast application or pinning supracondylar fracture and short arm cast application for forearm bone injury or closed reduction and percutaneous pinning for both injuries [5,8]. Choosing best management options for floating elbow is challenging.…”

Section: Introductionmentioning

confidence: 99%

“…Some of the textbooks of pediatric orthopedics do not make a mention of floating elbow injury [4]. The incidence of floating elbow injuries is between 3-13% [5]. It is a severe injury and some authors have reported a high incidence of compartment syndrome and in most cases they are associated with highenergy trauma [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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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%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ipsilateral fracture of the supracondylar humerus and forearm in children

Hussain¹

2014

IJCRI

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Is there benefit to concurrent x‐ray imaging of the wrist, forearm and elbow in paediatric patients following a fall on the outstretched hand?

Sgualdino

Neep

Spuur

et al. 2022

J of Medical Radiation Sci

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Introduction Concurrent X‐ray imaging of the wrist, forearm and elbow in paediatric patients following a fall on the outstretched hand (FOOSH) is intended to minimise the risk of an undetected co‐occurring injury and is typically performed on patients aged 0–10 years. The purpose of this study was to explore the benefit of this strategy and to identify if age could provide evidence for imaging. Methods A 12‐month retrospective review of all X‐ray examinations of the wrist, forearm and distal humerus of patients aged 0–10 years referred from the Emergency Department of Logan Hospital, Queensland was undertaken. The frequency, type and location of radiographic abnormalities and the requested examinations region of interest (ROI), referral notation and patient's age were recorded. Analysis was made by descriptive statistics. Results Four hundred and seventy‐six examinations met the studies inclusion criteria, 4.8% (n = 23) identified an abnormality outside of the documented ROI. On review of the admission and treatment notes, 1.7% (n = 8) were deemed to have detected traumatic abnormalities as a direct outcome of concurrent imaging. No age‐related evidence for imaging was identified. Conclusion This study demonstrates limited benefit (1.7%) to concurrent imaging following a FOOSH. The results suggest that a thorough physical evaluation of the paediatric upper limb performed by the referrer is sufficient to accurately guide X‐ray imaging. These findings have the potential to positively impact a reduction in the number of X‐rays performed on paediatric patients and in turn contribute to limiting radiation dose. Further studies may be beneficial in verifying the study's findings.

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Simultaneous Ipsilateral Fracture of the Elbow, Forearm and Wrist in a Child

Moonot

Nadkarni²,

Haddad³

2005

Eur J Trauma

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European Journal of Trauma Ab stractThe simultaneous occurrence of ipsilateral humeral supracondylar, forearm and wrist fractures is an uncommon injury. This fracture pattern is very difficult to treat, but no detailed cases were found in the English literature. A case of this unusual combination in a teenager is reported, successfully managed by open reduction and Kirschner wire (K-wire) fixation of the elbow fracture with open reduction of the forearm fractures and fixation with long intramedullary K-wires. Key WordsSupracondylar fracture of humerus · Ipsilateral fracture · Floating elbow · Segmental fracture of ulna Eur J Trau ma 2005;31:271-3

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Supracondylar Fractures of the Humerus Associated With Ipsilateral Forearm Fractures in Children: A Report of Forty-seven Cases

Cited by 32 publications

References 20 publications

Ipsilateral fracture of the supracondylar humerus and forearm in children

Ipsilateral fracture of the supracondylar humerus and forearm in children

Is there benefit to concurrent x‐ray imaging of the wrist, forearm and elbow in paediatric patients following a fall on the outstretched hand?

Simultaneous Ipsilateral Fracture of the Elbow, Forearm and Wrist in a Child

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