Capitellar Fractures in Children

Abstract

STRESZCZENIEWstęp. Zła ma nia głów ki ko ści ra mien nej wy stę pu ją nie zwy kle rzad ko. W pol skim pi śmien nic twie brak donie sień oma wia ją cych le cze nie tych zła mań. Pra ca ma na ce lu przed sta wie nie wła snych wy ni ków le cze nia i porów na nie ich z do nie sie nia mi in nych au to rów.Ma te riał i me to dy. Przed sta wio no gru pę 9 cho rych w wie ku 7-17 lat (śr. 14 lat). U jed ne go cho re go (11%) wy stą pi ło zła ma nie nie prze miesz czo ne, zaś u 8 (89%) cho rych zła ma nie by ło prze miesz czo ne po wy żej 2 mm. Od po wied nio do ro dza ju zła ma nia za sto so wa no le cze nie za cho waw cze u jed ne go cho re go, zaś ope ra cyj ne u po zo sta łych. U dzie ci le czo nych ope ra cyj nie, głów kę ko ści ra mien nej ze spo lo no 1x śru bą biow chła nial ną, zaś 7x dru ta mi Kir sch ne ra. Do oce ny obiek tyw nej funk cji łok cia uży to ska li: Mayo El bow Sco re (MES), na tomiast su biek tyw nej oce ny funk cji łok cia pa cjent do ko ny wał na pod sta wie Oxford El bow Sco re (OES).Wnio ski. 1. Nie prze miesz czo ne zła ma nia głów ki ko ści ra mien nej po win ny być le czo ne za cho waw czo. 2. Zła ma nia z prze miesz cze niem po wy żej 2 mi li me trów na le ży na sta wić ope ra cyj nie z prze zskór ną sta bi li za cją dru ta mi Kir sch ne ra.Słowa kluczowe: złamanie główki kości ramiennej; złamania kończyny górnej; złamania kości ramiennej u dzieci; złamania stawowe łokcia SUMMARY Background. Capitellar fractures are extremely rare. The Polish literature does not provide any reports on the treatment of these fractures. The aim of this paper is to present our treatment results and to compare them with reports from other authors.Material and methods. We investigated a group of 9 patients aged 7-17 years (mean age 14 years). One patient (11%) had sustained a non-displaced fracture, while 8 (89%) had sustained fractures with more than 2 mm displacement. According to the type of fracture, one patient was treated conservatively and the others underwent surgical treatment. In the children who were operated on, the humeral capitulum was fixed with a bioabsorbable pin in one patient and with K-wires in seven patients. Objective elbow function was evaluated using the Mayo Elbow Score (MES). Subjective elbow function was evaluated by patients on the basis of the Oxford Elbow Score (OES).Conclusions. 1. Non-displaced capitellar fractures should be treated conservatively. 2. Fractures with more than 2 mm displacement should be reduced surgically with percutaneous fixation with K-wires.

Therapeutic analysis of Herbert screw fixation for capitellar fractures via the anterior approach in adolescent patients

“…To date, no unified opinion exists on the surgical approaches and fixation selection for the treatment of capitellar fractures [ 1 , 5 , 7 , 8 ]. The lateral and posterior approaches are the most commonly used surgical methods for elbow joint surgery [ 9 ], but for the treatment of capitellar fractures, the lateral and posterior approaches provide poor exposure to the fracture, which hinders fracture reduction and internal fixation [ 10 ].…”

Therapeutic Analysis of Herbert Screw Fixation for Capitellar Fractures via the Anterior Approach in Children

“…To date, there is no uni ed opinion on the surgical approach and xation selection for the treatment of capitellar fractures [1,5,7,8]. The lateral and posterior approach are the most commonly used surgical approaches for elbow joint surgery [9].…”

Classification and Treatment of Pediatric Capitellar Fractures

“…Pediatric capitellar fractures are rare injuries, representing <1% of elbow fractures in children 1,2 . The existing literature is mostly comprised of small case series, and these injuries are often misdiagnosed or diagnosed late 3 .…”

“…P ediatric capitellar fractures are rare injuries, representing < 1% of elbow fractures in children. 1,2 The existing literature is mostly comprised of small case series, and these injuries are often misdiagnosed or diagnosed late. 3 In fact, the subtle radiographic changes associated with capitellar fractures are often present as the so-called "TRASH" (The Radiographic Appearance Seemed Harmless) lesion.…”