Closed Reduction and Percutaneous Pinning for Supracondylar Fractures of Humerus in Vietnamese Children

Trung, Dung Tran; Van, Nam Le; Huu, Vien Nguyen; Nguyen, Chinh Dao; Ngoc, Ha Nguyen; Nga, Vu Thi; Dinh, Toi Chu

doi:10.3889/oamjms.2019.355

Cited by 3 publications

(1 citation statement)

References 18 publications

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“…Titles and abstracts were screened, and 52 articles were retrieved for full-text evaluation and 25 studies met the inclusion criteria and were included in the systematic review. 4,[12][13][14][15]17,19,20,[22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] The PRISMA flow chart (Figure 1) shows the study selection.…”

Section: Resultsmentioning

confidence: 99%

Iatrogenic ulnar nerve palsy associated with supracondylar humeral fracture in children: A systemic review on its management

Ikram,

Shahzad,

Gnanou

2023

Trauma

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Background Supracondylar humeral fractures (SCHFs) are among the most common pediatric fractures. Closed reduction and percutaneous pinning are considered the established gold standard. Biomechanically, cross-pinning is resilient for any axial rotation, but the medial pin increases the risk of iatrogenic injury to the ulnar nerve. Objective A systematic review was conducted to provide an evidence-based analysis of the literature on the management of iatrogenic ulnar nerve injury caused by the medial pin during closed reduction and percutaneous fixation of displaced SCHF in children. Methods MEDLINE, SCOPUS, and ScienceDirect databases were searched to identify all articles that reported ulnar nerve injury caused by the medial pin during closed reduction and percutaneous fixation of displaced SCHF in children and suggested the management. Reference lists from the articles retrieved were further scrutinized to identify any additional studies of interest. Results One thousand six hundred and six articles on SCHF treated by closed reduction and cross-pinning were identified initially with 25 studies included in the analysis after screening. Four thousand six hundred and seventy-five children sustained SCHF with a median age of 7 years. Of 3036 children treated by closed reduction and cross pinning, 205 (6.75%) were diagnosed with iatrogenic ulnar nerve injury. The management involves observation only, removal of the medial pin, or exploration. The average recovery time in the group treated by removal of wire was statistically shorter than the other two groups. Conclusion The evidence suggests surgical exploration of the ulnar nerve can be delayed for up to 7 months, with most studies favouring observation only. In selected cases, immediate removal of the medial pin should be considered.

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Section: Resultsmentioning

confidence: 99%

Iatrogenic ulnar nerve palsy associated with supracondylar humeral fracture in children: A systemic review on its management

Ikram,

Shahzad,

Gnanou

2023

Trauma

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Supracondylar Fractures in Children: A Systematic Review of Treatment Options

Higuchi,

Oliveira,

Alves

et al. 2024

Acta ortop. bras.

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Objective: To compare the outcomes of surgical stabilization of pediatric supracondylar humeral fractures with the use of crossed Kirschner wires versus divergent lateral pinning wires. Methods: This is a systematic review with meta-analysis carried out by searching the MEDLINE/PubMed, Science Direct and Scielo databases. In these, the search for journals was carried out between January and August 2023, where 695 studies were found. To assess the quality of the studies, the Jadad and the MINORS scales were used.. The selection and reading of relevant articles were carried out by the researchers and 11 studies met the selection criteria. Results: From the 11 selected studies, 963 patients who met the criteria for the surgical treatment of these fractures were grouped. After the statistical analysis, we found that the ulnar nerve injury had a higher incidence when the crossed-K wire technique was used; and the lateral fixation is safer for the ulnar nerve. Conclusion: Both fixation techniques determine good functional results. However, fixation with lateral Kirschner wires proves to be safer considering the risk of iatrogenic injury to the ulnar nerve. Crossed-K wire fixation is more effective in terms of stability and maintenance of fracture reduction. Level of Evidence II, Systematic Review of Level II or Level I Studies with discrepant results.

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Complications and Outcomes of Surgically Treated Pediatric Supracondylar Humerus Fractures

Hahn,

Schuller,

Pichler

et al. 2024

Children

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This study describes the outcome of supracondylar humerus fractures in children using crossed K-wires after closed or open reduction with the medial, lateral or bilateral approach. Patients treated between January 2000 and December 2019 were classified according to the Von Laer classification, complications were classified according to the Sink classification and clinical outcomes were classified according to modified Flynn criteria. In total, 364 patients with a mean age of 5.23 ± 2.45 years were included. The majority were type IV fractures (156; 42.9%) and 94 (60.3%) needed an open reduction for which the medial approach (53; 56.4%) was predominantly used. Overall, of 50 complications (31 using closed reduction, 19 open reduction), 17/50 (34%) needed revision surgery. An excellent clinical outcome was achieved in 348/364 (95.6%) patients. The approach used for open reduction as such had no influence on the complication rate or clinical outcome. For severely displaced fractures, the data showed that an open approach for crossed K-wires tended to result in fewer complications and better clinical outcomes than a closed reduction. If an open reduction is indicated, the required approach (medial, lateral or bilateral) should be primarily selected according to the requirements of the fracture pattern and eventual cosmetic considerations.

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Closed Reduction and Percutaneous Pinning for Supracondylar Fractures of Humerus in Vietnamese Children

Cited by 3 publications

References 18 publications

Iatrogenic ulnar nerve palsy associated with supracondylar humeral fracture in children: A systemic review on its management

Iatrogenic ulnar nerve palsy associated with supracondylar humeral fracture in children: A systemic review on its management

Supracondylar Fractures in Children: A Systematic Review of Treatment Options

Complications and Outcomes of Surgically Treated Pediatric Supracondylar Humerus Fractures

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