9 years’ follow-up of 168 pin-fixed supracondylar humerus fractures in children

Tuomilehto, Noora; Sommarhem, Antti; Nietosvaara, Aarno Y.

doi:10.1080/17453674.2018.1438765

Cited by 12 publications

(12 citation statements)

References 21 publications

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“…Surgeon experience is another influencing factor for SCHFs-treated patient outcome [41]; Tuomilehto et al [42] reported a slightly higher rate of complications, but no differences in the quality of reduction between residents and senior orthopaedic surgeons; otherwise, the open reduction rate increases when the surgeon is a resident [8].…”

Section: Discussionmentioning

confidence: 99%

Is Supine Position Superior to Prone Position in the Surgical Pinning of Supracondylar Humerus Fracture in Children?

Pavone

Vescio

Riccioli

et al. 2020

JFMK

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Background: Supracondylar humerus fracture (SCHF) is a frequent injury in pediatric ages. Closed reduction and percutaneous pin fixation is a common treatment of displaced SCHF. Surgery is usually performed in the supine position; otherwise the prone position allows an easier fracture reduction and a safe placement of pins. The aim of study is to compare the clinical and radiographic results of the treatment of displaced SCHF, comparing two different intra-operative positionings. Methods: 59 SCHF affected children were retrospectively divided into supine (Group 1; n = 34) and prone (Group 2; n = 25), according to intraoperative position. All treated subjects were clinically evaluated according to Flynn’s criteria and Mayo Elbow Performance Score, and radiographically, including the measurement of the Baumann angle. Results: Clinically, Group 1, according Flynn’s criteria, had excellent cosmetic outcome in 32 subjects (94.1%). Mean MAYO Score was 96.0 ± 3.8. Group 2, according Flynn’s criteria, had excellent cosmetic outcomes in 23 subjects (92.0%). Mean MAYO Score was 97.8 ± 3.3. Radiographically, mean difference of Baumann’s angle between the injured limb and the normal limb was 5.5° ± 1.0° in Group 1 and 5.1° ± 1.1° in Group 2. Conclusion: Both supine and prone positioning achieved a satisfying outcome with similar results in joint function recovery and complications.

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Section: Discussionmentioning

confidence: 99%

Is Supine Position Superior to Prone Position in the Surgical Pinning of Supracondylar Humerus Fracture in Children?

Pavone

Vescio

Riccioli

et al. 2020

JFMK

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show abstract

“…Recently, Tuomilehto et al 29 reported a slightly higher rate of complications but no differences in the quality of reduction between residents and senior orthopaedic surgeons, although the findings were not statistically significant. Our study showed a significantly higher risk of complications in patients operated on by paediatric surgeons (55%) than by orthopaedic surgeons (15%), and the residents (37%) were between these two groups.…”

Section: Discussionmentioning

confidence: 93%

Paediatric supracondylar humeral fractures: The effect of the surgical specialty on the outcomes

Saarinen

Helenius

2019

Journal of Children's Orthopaedics

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Purpose The effect of surgical specialty on the outcomes of paediatric patients treated for displaced supracondylar humeral fractures remains unclear. The results of residents, paediatric surgeons and orthopaedic surgeons were compared. Methods A retrospective review of 108 children (0 to 16 years) treated for displaced humeral supracondylar fractures (Gartland II or III) requiring closed or open reduction under general anaesthesia were included. The patient charts and radiographs were evaluated to identify type, grade and neurovascular complications. Operative performance (operative time, quality of reduction, need for open reduction, complications) of residents, paediatric surgeons and orthopaedic surgeons were evaluated. Results Residents used a crossed pin configuration for patients in 25/25 (100%), paediatric surgeons in 25/32 (78%) and orthopaedic surgeons in 33/33 (100%) (p = 0.0011). Loss of reduction was present in one patient treated with crossed pins, in two with lateral pins and in two without Kirschner-wires (p = 0.0034). The risk ratio of an unacceptable reduction was 4.0 (95% confidence interval (CI) 0.90 to 18, p = 0.070) for residents and 6.6 (95% CI 1.6 to 27, p = 0.0082) for paediatric surgeons as compared with orthopaedic surgeons. Complications were present in 37% of patients (11/30) for residents, 55% (24/44) for paediatric surgeons and 15% (5/34) for orthopaedic surgeons (p = 0.0013). Conclusion We found statistically significant differences in the incidence of unacceptable reduction, complications and the usage of crossed pin configuration between the surgical specialties. Patients would benefit from the practice of assigning the operative treatment of displaced supracondylar fractures to orthopaedic surgeons. Level of evidence: Level III

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“…Supracondylar humerus fractures are of great significance as their conservative or surgical treatment could have an effect on the patient’s future lifestyle; these fractures also affect hand, wrist, and forearm movements. Therefore, their treatment is very important to prevent future functional and cosmetic morbidities [5,6]. The treatment of supracondylar humerus fractures, which occur in the neurovascular region and due to trauma or iatrogenic causes, requires sufficient experience and skill [5].…”

Section: Introductionmentioning

confidence: 99%

Temporary Fixation of Reduction with Fabric Adhesive Bandage in the Surgical Treatment of Pediatric Supracondylar Humerus Fractures

et al. 2019

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Background and objectives: Supracondylar humerus fractures are common in children andcan be surgically treated. However, the general surgical procedures involving reduction andfixation might lead to reduction loss, failure to direct the Kirschner (K)-wire toward the desiredposition, prolonged surgery, or chondral damage. This study aimed to show that temporaryfixation of closed reduction with a fabric adhesive bandage in pediatric supracondylar humerusfractures could maintain reduction so that surgical treatment can be easily performed by a singlephysician. Materials and Methods: Forty-six patients with Gartland type 3 supracondylar humerusfractures who underwent surgical treatment between May 2017 and June 2018 were retrospectivelyevaluated. Fluoroscopy-guided reduction and fixation were performed from the distal third of theforearm to the proximal third of the humerus using a fabric adhesive bandage. Two crossed pinswere applied on the fracture line by first inserting a lateral-entry K-wire and then inserting anotherK-wire close to the anterior aspect of the medial epicondyle and diverging from the ulnar nervetunnel. A tourniquet was not applied in any patient and no patients required open reduction.Results: The study included 32 boys (69.6%) and 14 girls (30.4%) (mean age, 7.1; range, 2–16 years).The mean hospital stay and follow-up duration were 4.3 ± 3.9 days and 48.1 ± 14.3 weeks,respectively. Heterotopic ossification was detected in one patient, and ulnar nerve neuropraxia wasdetected in another patient. Functional (according to Flynn criteria) and cosmetic outcomes wereexcellent in 95.6%, moderate in 2.2%, and poor in 2.2% of patients. The mean duration of fixation ofthe closed reduction with a fabric adhesive bandage was 8.1 ± 3.9 min, and the mean duration ofpinning was 7.9 ± 1.4 min. Conclusions: Temporary preoperative fixation of supracondylar humerusfractures that require surgical treatment with a fabric adhesive bandage may be significantlyconvenient in practice.

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9 years’ follow-up of 168 pin-fixed supracondylar humerus fractures in children

Cited by 12 publications

References 21 publications

Is Supine Position Superior to Prone Position in the Surgical Pinning of Supracondylar Humerus Fracture in Children?

Is Supine Position Superior to Prone Position in the Surgical Pinning of Supracondylar Humerus Fracture in Children?

Paediatric supracondylar humeral fractures: The effect of the surgical specialty on the outcomes

Temporary Fixation of Reduction with Fabric Adhesive Bandage in the Surgical Treatment of Pediatric Supracondylar Humerus Fractures

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