The Relationship between the Dominant Hand and the Occurrence of the Supracondylar Humerus Fracture in Pediatric Orthopedics

Herdea, Alexandru; Ulici, Alexandru; Toma, Adrian Ioan; Voicu, Bogdan; Charkaoui, Adham

doi:10.3390/children8010051

Cited by 6 publications

(7 citation statements)

References 14 publications

(20 reference statements)

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“…In contrast, OI results in impaired bone mineralization, allowing for fractures after much less imparted energy. We postulate that many OI HWFs occur in the dominant hand as a result of injury during daily use, aligning with the current literature on handedness 11,12 …”

Section: Discussionsupporting

confidence: 74%

“…We postulate that many OI HWFs occur in the dominant hand as a result of injury during daily use, aligning with the current literature on handedness. 11,12 OI HWFs present commonly as transverse fractures, with buckle and avulsion fractures less common in the OI population. The differences in observed fracture morphology may be due to the bone quality in patients with OI; however, prior studies have reported radiographically normal appearance of nonfractured hand and wrist bones in patients with OI.…”

Section: Discussionmentioning

confidence: 99%

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Pediatric Hand and Wrist Fractures in Osteogenesis Imperfecta: An Analysis of Incidence, Patient-specific Risk Factors, and Fracture-specific Characteristics

Chhabra,

Phillips,

Mitchell

et al. 2023

Journal of Pediatric Orthopaedics

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Background: Children with osteogenesis imperfecta (OI) frequently present with fractures; however, hand and wrist fractures (HWFs), those distal to the radial and ulnar diaphysis, are seldom observed. Yet, HWFs remain among the most common fractures in children with non-OI. The objective of this study was to identify the incidence of OI HWFs. Secondary objectives aimed at identifying patient-specific risk factors for HWFs in OI and comparing clinical courses to non-OI HWFs. Methods: A retrospective cohort study was conducted. Database query by ICD-10 codes identified 18 patients with OI HWF, 451 patients with OI without HWFs, and 26,183 patients with non-OI HWF. Power analysis estimated appropriate sample sizes and random sampling was utilized to collect patients. Patient demographics, OI-specific variables, fracture morphology, and fracture clinical courses were recorded. Data were analyzed for patient-specific and fracture-specific factors affecting OI HWF incidence. Results: Of patients with OI, 3.8% (18/469) sustained HWFs. Patients with OI HWF were significantly older than patients with OI without HWFs (P = 0.002) with no differences in height, weight, ethnicity, sex, or ambulatory status. Compared with non-OI HWFs, patients with OI HWF were significantly shorter (P < 0.001), weighed less (P = 0.002), and were less likely to be ambulatory (P < 0.001). OI HWFs were more commonly on the side of hand dominance (P < 0.001) with transverse patterns (P = 0.001). OI HWFs were less frequent in the thumb (P = 0.048) and trended towards significance in the metacarpals (P = 0.054). All OI HWFs were treated nonoperatively with similar union rates and refracture rates to non-OI HWFs. Multivariate regression showed that older patient age (odds ratio: 1.079, 95% CI: 1.005,1.159, P = 0.037) and OI type I (odds ratio: 5.535, 95% CI: 1.069, 26.795, P = 0.041) were significant prognosticators for HWFs in patients with OI. Conclusion: OI HWFs are uncommon (3.8%, 18/469) but specific HWF morphologies and locations are more common in patients with OI; however, these are not pathognomonic. Older patients with mild penetrance of type I OI are at the highest risk for HWFs. OI HWFs do well when managed nonoperatively with noninferior clinical courses compared with non-OI HWFs. Level of Evidence: Level III.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Pediatric Hand and Wrist Fractures in Osteogenesis Imperfecta: An Analysis of Incidence, Patient-specific Risk Factors, and Fracture-specific Characteristics

Chhabra,

Phillips,

Mitchell

et al. 2023

Journal of Pediatric Orthopaedics

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“…It is most common in children aged 5 to 7 years old, with the non-dominant hand more frequently involved. No substantial difference was observed between boys and girls [1][2][3][4].…”

Section: Introductionmentioning

confidence: 73%

Pediatric Supracondylar Fracture of the Humerus with Sideward Displacement

Zaidman

Eidelman

Abu-Dalu

et al. 2023

Surgical Techniques Development

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Background: Supracondylar humeral fracture is probably the most common elbow fracture in children requiring surgical intervention. We observed a subtype of pediatric supracondylar humeral fracture with a sideward translation, without substantial displacement in the sagittal plane on initial radiographs. The purpose of this study was to calculate the incidence of this fracture subtype and suggest a modification to the standard operative technique, to achieve the desired fracture alignment and fixation. Methods: We reviewed the clinical records and radiographs of all pediatric patients with supracondylar humeral fractures surgically treated in our institution between the years 2006 and 2014. The fracture types, fixation configuration and any complications were recorded. Results: Overall, 263 consecutive patients were included. The incidence of supracondylar fracture of the humerus with solely sideward displacement was 6%. The fracture was characterized clinically and radiographically. We proposed a modification to the standard operative technique for this fracture subtype for successful closed reduction and percutaneous pinning. Conclusions: Special attention to this fracture subtype, including appropriate operating room setup and the application of a suitable reduction and pinning technique, has the potential to achieve successful results and avoid the need for open reduction.

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“…For pain intensity assessment, we used the Numerical Rating Scale for patients older than ten years, and the Wong-Baker Faces Pain Rating Scale/Faces Pain Scale for pediatric patients between the ages of 3 and 10 [9, [13][14][15][16][17].…”

Section: Methodsmentioning

confidence: 99%

Evaluating the Functional Outcomes and the Quality of Life for Pediatric Patients with Osteogenesis Imperfecta after Fracture Treatment with Intramedullary Rodding

et al. 2021

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Background and Objectives: Osteogenesis imperfecta is a rare pathology involving the bones and the connective tissues, generating alterations that lead to frequent fractures during childhood. When fractures occur at birth, they are associated with an impairment of walking and the quality of life. Although surgical techniques have significantly improved in recent years, functional outcomes and the quality of life for pediatric patients that benefited from surgical management with telescopic rods have been less evaluated. This study aimed to measure functional results and determine the factors that influence the quality of life for the pediatric population diagnosed with Osteogenesis imperfecta and surgically treated using the telescopic rod approach after suffering a fracture or severe deformity. Materials and Methods: We conducted a cohort study that consisted of 15 patients diagnosed with Osteogenesis imperfecta (average age of 11.6 years). All individuals possessed at least one intramedullary telescopic rod as a result of the surgical treatment. Results: We observed that the pain, both acute and chronic, impairs the quality of life and interferes with daily living activities, for instance, self-care tasks. Conclusions: Osteogenesis imperfecta is associated with a severely damaged level of walking. All of the aspects of the pediatric patient’s daily life activity seem to be affected. Furthermore, these patients, especially those residing in rural areas, have a poor quality of life.

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The Relationship between the Dominant Hand and the Occurrence of the Supracondylar Humerus Fracture in Pediatric Orthopedics

Cited by 6 publications

References 14 publications

Pediatric Hand and Wrist Fractures in Osteogenesis Imperfecta: An Analysis of Incidence, Patient-specific Risk Factors, and Fracture-specific Characteristics

Pediatric Hand and Wrist Fractures in Osteogenesis Imperfecta: An Analysis of Incidence, Patient-specific Risk Factors, and Fracture-specific Characteristics

Pediatric Supracondylar Fracture of the Humerus with Sideward Displacement

Evaluating the Functional Outcomes and the Quality of Life for Pediatric Patients with Osteogenesis Imperfecta after Fracture Treatment with Intramedullary Rodding

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