Systematic pinning of displaced extension-type supracondylar fractures of the humerus in children

Mazda, Keyvan; Boggione, C.; Fitoussi, F.; Penneçot, Georges-François

doi:10.1302/0301-620x.83b6.11544

Cited by 88 publications

(81 citation statements)

References 15 publications

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“…Excellent functional results have been reported [7,8,13,16,18], however, to our knowledge, there are no published descriptions of the time of the return of motion after treatment of these injuries. We aimed to assess return of elbow motion after closed reduction and percutaneous pinning of displaced pediatric supracondylar fractures.…”

Section: Discussionmentioning

confidence: 96%

“…Currently, the most popular management of these fractures that are displaced is closed reduction and percutaneous pinning [9,11,21]. Numerous studies have documented excellent functional outcome with elbow motion within 5°of the motion of the uninjured elbow in the majority of patients [7,8,13,16,18]. Elbow motion within 5°of the motion of the uninjured elbow was reported in 94% (77 of 82) of patients by Mazda et al [8] at a 28-month mean followup, in 92% (58 of 63) of patients by Shim and Lee [16] at a 17-month mean followup, and in 90% (55 of 61) of patients by Lee et al [7] at a 28-month mean followup.…”

Section: Introductionmentioning

confidence: 99%

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Time of Return of Elbow Motion after Percutaneous Pinning of Pediatric Supracondylar Humerus Fractures

Zionts

Woodson

Manjra

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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The most common treatment for displaced pediatric supracondylar humerus fractures is closed reduction and percutaneous pinning. However, the time for return of elbow motion after treatment of these injuries is not well documented. To describe the return of elbow motion after closed reduction and percutaneous pinning of these fractures we retrospectively reviewed 63 patients (age range, 1.6-13.8 years) with displaced supracondylar fractures of the humerus stabilized with either two or three lateral entry pins. Pins were removed by 3 to 4 weeks. No patient participated in formal physical therapy. At each followup, elbow range of motion (ROM) was recorded for the injured and uninjured extremities. Elbow ROM returned to 72% of contralateral elbow motion by 6 weeks after pinning and progressively increased to 86% by 12 weeks, 94% by 26 weeks, and 98% by 52 weeks. After closed reduction and percutaneous pinning of a displaced, uncomplicated, supracondylar humerus fracture, 94% of the child's normal elbow ROM should be expected by 6 months after pinning. Further improvement may occur up to 1 year postoperatively. This information may be helpful in advising parents what to expect after their child's injury.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Time of Return of Elbow Motion after Percutaneous Pinning of Pediatric Supracondylar Humerus Fractures

Zionts

Woodson

Manjra

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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show abstract

“…Percutaneous pinning is a popular method of choice for supracondylar fractures [6][7][8] and has been reported to be a safe and cost-effective method that provides good functional results [7][8][9][10]. Even dislocated supracondylar fractures can be treated by repositioning and casting with an excellent functional outcome [11].…”

Section: Introductionmentioning

confidence: 99%

Increased incidence of distal humeral fractures and surgical treatment in 0- to 18-year-old patients treated in Finland from 1987 to 2010

Salonen

Pajulo

Lahdes-Vasama

et al. 2013

Journal of Children's Orthopaedics

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Background Studies of pediatric and adolescent fractures in general report a significant increase in the incidence of upper-extremity fractures as well as in their surgical treatment. The aim of this study was to determine the trends of the incidence and treatment of distal humeral fractures in hospitalized 0-to 18-year-old patients in Finland. Method The study included the entire pediatric and adolescent (\19 years) population in Finland during the 24-year period from 1 January 1987 to 31 December 2010. Data on hospitalized patients were obtained from the nationwide National Hospital Discharge Registry where information is collected from all hospital categories (private, public, and other). Surgical treatment was categorized into three groups; (1) reposition with casting; (2) reposition or reduction and osteosynthesis; (3) reposition or reduction and external-fixation and other fixation methods. Patients were classified into three groups according to age: 0-6 years, 7-13 years, and 14-18 years. Annual incidences were calculated using the annual mid-year population census obtained from the Official Statistics of Finland. Results During the 24-year study period, there were a total of 12,590 hospitalizations with a main or secondary diagnosis of distal humeral fracture. In children aged 0-12 years the overall incidence of hospitalization increased 30 % during the 24-year study period, from 4.5 per 10,000 person-years in 1987 to 5.8 per 10,000 person-years in 2010. There were a total of 5,548 operations. During the study period, surgical treatment by repositioning or reduction with osteosynthesis due to a distal humeral fracture increased by fivefold in patients aged\6 years and by twofold in patients aged 7-12 years of age. The incidences of fracture and treatment in children older than 13 years did not change. Conclusion The incidence of distal humeral fractures and the incidence of repositioning with osteosynthesis increased remarkably in prepubertal children during the 24-year study period in Finland.

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“…There is no consensus on the timing of surgery, approach for open reduction and configuration of fixation wires 13 . Closed reduction and per-cutaneous K-wire fixation is the the preferred treatment option when intraoperative imaging facilities is available 14,15 , but it is associated with 4% to 15% iatrogenic ulnar nerve injury 16 . Clinically, accurate localization of ulnar nerve by palpation may be misleading, the medially inserted pin always posing a danger to the nerve 17 .…”

Section: Discussionmentioning

confidence: 99%

open reduction and Internal Fixation of displaced Supracondylar Fractures of humerus with Crossed K-wires via Medial Approach

Hussain¹,

Dhar²,

Qayoom³

et al. 2014

MOJ

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This study aimed at evaluating the medial approach for open reduction and internal fixation of Gartland type 3 displaced supracondylar fractures of humerus in children. A prospective, single centre study of on displaced supracondylar humerus fractures in 42 children was carried out at our institute. All fractures were managed with open reduction and internal fixation with crossed K-wires via medial approach. The mean follow-up was 12 months and patients were assessed according to Flynn's criteria. No patients had post-operative ulnar nerve injury. Cubitus varus was not seen in any patient. Superficial pin tract infection occurred in three patients that subsided with anti-septic dressings and antibiotics. No deep infection occurred. 88.09 % patients showed satisfactory results as per Flynn's criteria. The medial approach provides an excellent view of the supracondylar area. The approach is convenient due to a lower risk for ulnar nerve injury and better acceptability of the medial incisional scar.

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Systematic pinning of displaced extension-type supracondylar fractures of the humerus in children

Cited by 88 publications

References 15 publications

Time of Return of Elbow Motion after Percutaneous Pinning of Pediatric Supracondylar Humerus Fractures

Time of Return of Elbow Motion after Percutaneous Pinning of Pediatric Supracondylar Humerus Fractures

Increased incidence of distal humeral fractures and surgical treatment in 0- to 18-year-old patients treated in Finland from 1987 to 2010

open reduction and Internal Fixation of displaced Supracondylar Fractures of humerus with Crossed K-wires via Medial Approach

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