Transphyseal separation of the distal humerus in newborns

Gigante, Cosimo; Kini, Sunil Gurpur; Catena, Nunzio; Volpin, Andrea

doi:10.1016/j.cjtee.2017.04.003

Cited by 18 publications

(29 citation statements)

References 22 publications

(65 reference statements)

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“…Auch in jüngster Zeit wird erneut von der Fehldiagnose einer Ellbogenluxation bei eigentlich vorliegender Humerus Epiphysiolyse (HE) berichtet [14]. Als geburtstraumatische Verletzung hat die neonatale HE (auch transphyseale Ellbogenfraktur genannt) eine Inzidenz von 0,09 pro 1000 Geburten und kommt bei schwierigen Armentwicklungen vor [15].…”

Section: Diskussionunclassified

Ellbogenluxation bei Geburt? – Differenzialdiagnose von Ellbogenpathologien bei Geburt

Pokall¹,

Sterniste²,

Pärtan³

et al. 2019

Z Geburtshilfe Neonatol

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ZusammenfassungWir berichten einen Fall von isolierter Kongenitaler Radiusköpfchenluxation (kRKL) bei einem Neugeborenen nach vaginaler Geburt aus Beckenendlage. Die Assoziationen dieser Geburtsmodalität führten zu der Fehldiagnose einer Ellbogenluxation. Die Ellbogenluxation ist eine häufige Fehldiagnose der kRKL, obwohl sie insbesondere bei Kindern unter einem Jahr bisher nicht berichtet wurde. Für den erfahrenen Kliniker führen jedoch die wiederholte klinische Untersuchung zusammen mit der geeigneten Bildgebung zum Ausschluß dieser Diagnose. Die kRKL kann bis in das Jugendalter asymptomatisch bleiben. Sofern keine Schmerzen oder funktionelle Beeinträchtigung vorliegen ist keine Therapie notwendig. Wir nahmen diesen Fall zum Anlass, neonatale Ellbogen-Auffälligkeiten in diesem Bericht zusammenzufassen.

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Section: Diskussionunclassified

Ellbogenluxation bei Geburt? – Differenzialdiagnose von Ellbogenpathologien bei Geburt

Pokall¹,

Sterniste²,

Pärtan³

et al. 2019

Z Geburtshilfe Neonatol

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“…Частота переломов плечевых костей при дистоции плечиков увеличивается в сравнении с общепопуляционной и составляет уже 3 % клинических наблюдений [38,39]. Средний срок постановки диагноза перелома плечевой кости у новорожденных составляет около 40 часов с момента родов [40], при этом большую диагностическую ценность, кроме рентгенографии, имеет ультразвуковое исследование травмированной конечности [34,[41][42][43]. Дифференциальную диагностику перелома плеча следует проводить прежде всего с брахиальным плекситом, остеомиелитом, вывихом костей предплечья и врожденными аномалиями развития [35,44].…”

Section: результаты и обсуждениеunclassified

“…Лечение переломов, как правило, консервативное с помощью гипсовых лонгет и фиксирующих повязок [41,42], но в ряде случаев возможно применение металлоконструкций [40,43]. Так, С. Ratti et al [23] сообщают, что при лечении 33 новорожденных с интранатальными переломами плечевой кости в нижней трети в 29 (88,0 %) случаях использовались консервативные методики, в 4 (12,0 %) клинических наблюдениях -оперативные.…”

Section: результаты и обсуждениеunclassified

“…Лечение переломов бедренных костей у новорожденных, как правило, консервативное [40,42]. Для этих целей применяют, как уже указывалось выше, хорошо зарекомендовавшие себя консервативные методы [49][50][51].…”

Section: результаты и обсуждениеunclassified

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Fractures of long tubular bones in newborns: mechanisms of injuries, methods of diagnosis, and treatment

Скрябин

Геннадьевич²,

Akselrov

et al. 2018

Pediatr Traum Orthop Reconstr Surg

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Background. Medical information on the provision of emergency trauma care to newborns with fractures of tubular bones is scarce. Aim. This scientific review aimed to inform children's orthopedic traumatologists regarding the main mechanisms of injury, methods of diagnosis, and treatment of fractures of long tubular bones in newborns. Material and methods. The article presents a systematic analysis of 60 scientific works of domestic and foreign authors on topical aspects of fractures of long tubular bones in newborns from 1986 to 2018. For writing the literature review, we used modern electronic databases of medical information: PubMed, MEDLINE, Ulrich’s Periodicals Directory, DOAJ, Cyberleninka, and еLibrary. Results and discussion. Similarly from the analysis of scientific publications, the main mechanism of fractures of limb segments in newborns is intranatal trauma, in which the child can receive both during birth through the birth canal and during cesarean section. The predisposing factors for obtaining bone fractures are intrauterine osteopenia, congenital diseases of the digestive system, and prematurity. Fractures are diagnosed on the basis of clinical examination and results of ultrasound and X-ray studies of the injured limb. In the treatment of limb bone fractures, both conservative and surgical methods are used. In recent years, a tendency has been clearly observed in scientific publications, highlighting the ever-widening introduction into clinical practice of operational methods for stabilizing fractures of long tubular bones in newborns, including using the techniques of transosseous osteosynthesis. Conclusion. The presented article fills the existing gap of summarizing scientific publications on the treatment of fractures of limbs in newborns.

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“…Congenital diseases like congenital rickets, mucopolysaccharidosis, osteogenesis imperfecta, and other metabolic bone diseases may also be primary causes of the injury, in which neonatal fracture may be the first symptom of those diseases[ 2 , 3 ]. The main pathogenic mechanism is associated with the application of rotary shear force or traction to the epiphysis of the distal humerus, resulting in traumatic separation[ 2 , 4 , 8 - 10 ]. In neonates, the physis of the distal humerus is smooth and transverse without ossification centers, which is the weakest point of the distal humerus that is prone to physeal fractures due to rotary shear force or traction[ 3 , 7 , 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Percutaneous fixation of neonatal humeral physeal fracture: A case report and review of the literature

Tan

Wang

Yao

et al. 2020

WJCC

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BACKGROUND Neonatal distal humeral physeal fractures are rare and difficult to diagnose. Thus, missed diagnoses and delayed healing are possible. Few studies have reported surgical treatment, because a callus may develop at the fracture site 5 d after the fracture, resulting in difficult reduction, and reduction of the limb may cause further physeal injury. Other surgical challenges include the provision of adequate anesthesia and complexity of the operation. However, without appropriate reduction and fixation, a varus elbow deformity may develop. Manual reduction and percutaneous pin fixation are ideal treatment options. CASE SUMMARY A 4-day-old neonate with left elbow pain accompanied by limited movement for 4 d was admitted, and diagnosed with delayed physeal fracture of the distal humerus based on physical examination, ultrasonography, and magnetic resonance imaging. The patient was treated by manual reduction combined with percutaneous pin fixation under arthrography. Postoperatively, the reduction was successful. The upper limbs could have been lifted and the fingers could have been moved freely on the second day after the operation. CONCLUSION The techniques of manual reduction and percutaneous pin fixation, to treat neonatal distal humeral physeal fractures, are safe and reliable.

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Transphyseal separation of the distal humerus in newborns

Cited by 18 publications

References 22 publications

Ellbogenluxation bei Geburt? – Differenzialdiagnose von Ellbogenpathologien bei Geburt

Ellbogenluxation bei Geburt? – Differenzialdiagnose von Ellbogenpathologien bei Geburt

Fractures of long tubular bones in newborns: mechanisms of injuries, methods of diagnosis, and treatment

Percutaneous fixation of neonatal humeral physeal fracture: A case report and review of the literature

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