Traumatic separation of the distal epiphysis of the humerus sustained at birth

Jacobsen, S.; Hansson, Göran; Nathorst-Westfelt, J.

doi:10.1302/0301-620x.91b6.22140

Cited by 47 publications

(57 citation statements)

References 31 publications

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“…Some case reports or small case series have already been published; however, precise epidemiological data lack [1][2][3][4]. In a retrospective analysis of 105,119 births, 789 (0.75 %) of the neonates were found to have a fracture, but only one patient (0.0001 %) had a transphyseal fracture of the humerus [5].…”

Section: Introductionmentioning

confidence: 99%

Transphyseal elbow fracture in newborn: review of literature

et al. 2015

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Transphyseal elbow fracture is a rare entity in newborns, and in the last century, only case reports or small case series have been published; however, precise epidemiological data lack. Such fractures occur more often in emergency Caesarian section or vaginal delivery. The differential diagnosis with elbow dislocation can be challenging. Radiography, arthrography, magnetic resonance, ultrasound or a combination of these have already been described to make diagnosis, but guidelines for the management of this injury in the neonate are not well established. A review of the literature of the last century about distal transphyseal fracture of the humerus in newborns was performed. A bibliographic search was conducted accessing usual medical databases. The work-up methods, treatments, results at follow-up and the rate of complications were collected. Twenty case reports or small retrospective case series reporting a total of 33 cases were included. A posteromedial displacement of the radioulnar complex was found in 21 elbows (64 %). Four patients (12 %) underwent surgical treatment, whilst 29 (88 %) were managed without surgery. An attempt of reduction was reported in 23 cases (69 %). At follow-up, 88 % recovered completely the carrying angle and 80 % range of motion. A relationship between the type of treatment (conservative or surgical, with attempt of reduction or not) and results at follow-up could not be demonstrated. The most common complication was cubitus varus. Transphyseal elbow fractures are rare among newborns. Regardless of the treatment choice, such lesions are in most cases associated with a good prognosis.

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Section: Introductionmentioning

confidence: 99%

Transphyseal elbow fracture in newborn: review of literature

et al. 2015

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“…The risk factors for physeal injuries are difficult and instrumental deliveries, abnormal presentations, macrosomia and cephalopelvic disproportion. In our case, the neonate did not have history of birth trauma, child abuse or any obvious cause for the injury as against most of the previously reported cases, by Sherr Lurie N, Jacobsen S and Kaushal R, in which difficult labour or traction/ rotatory forces to the elbow was the cause for the injuries/ fracture [2,6,7].…”

Section: Resultsmentioning

confidence: 47%

“…Detailed examination of our child did not have any evidence of nerve injury. In a case series of six patients diagnosed with this fracture studied by Jacobsen S et al, the age of diagnosis varied from day one to thirty of life with majority being diagnosed late [6]. Our patient's diagnosis was established on day 14 of life when radiograph/ ultrasound revealed callus formation, though clinically the child had presented on day one of life.…”

Section: Resultsmentioning

confidence: 71%

“…[table/ Fig-2]: Radiograph on day 14 shows callus formation due to distal humerus transphyseal separation (diagnosed on ultrasonography) and posteromedial displace ment of radius and ulna and non-invasive technique for early diagnosis [2,6,8,9]. However, it is highly operator dependent and can be painful and uncomfortable in the setting of fracture [4].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Transphyseal Injury of Distal Humerus: A Commonly Missed Diagnosis in Neonates

Малик¹,

Khopkar²,

Cs³

et al. 2015

JCDR

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“…The classic but relatively uncommon radiographic fi nding is displacement of the epiphysis without an osseous fracture. This may be seen in infants with traumatic separation of the distal humerus, which usually results in posteromedial displacement of the distal fragment [ 19 ] ( Fig. 17.16 ) (see Chap.…”

Section: Classifi Cation Of Growth Plate Injurymentioning

confidence: 99%

Skeletal Trauma: General and Unique Considerations in Children

Ranson

2014

Pediatric Orthopedic Imaging

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This chapter presents common and unusual pediatric fracture patterns and mechanisms of injury. A detailed discussion of growth cartilage injury follows a brief presentation on cartilage development, reviewing the Salter-Harris classifi cation and the Ogden extended classification. Other unique pediatric injuries including apophyseal avulsion fractures and pediatric stress fractures are also discussed. Pediatric fracture healing and remodeling and potential complications are presented. Finally, there is a brief discussion of pediatric articular trauma.The dynamic state of the developing skeleton makes children susceptible to unique mechanisms of injury, resulting in specifi c fracture patterns. Pediatric fractures may result from acute or chronic/repetitive trauma; typical mechanisms of injury include a fall, motor vehicle collision, or sporting injury. The type of fracture that occurs depends on the child's age. Fractures in infants are often diaphyseal, whereas older children commonly sustain fractures involving the metaphysis or metadiaphysis (Fig. 17.1 ) [ 1 ]. Since pediatric bone is relatively elastic, several fractures-such as greenstick, buckle, and bowing injuries-are essentially limited to children. Growth plate fractures represent up to 25 % of all pediatric fractures, and additional growth cartilage injuries include osteochondral and apophyseal fractures [ 2 , 3 ].

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Traumatic separation of the distal epiphysis of the humerus sustained at birth

Cited by 47 publications

References 31 publications

Transphyseal elbow fracture in newborn: review of literature

Transphyseal elbow fracture in newborn: review of literature

Transphyseal Injury of Distal Humerus: A Commonly Missed Diagnosis in Neonates

Skeletal Trauma: General and Unique Considerations in Children

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