Diagnostic arthroscopy in the treatment of minimally displaced lateral humeral condyle fractures in children

Temporin, Ko; Namba, Jiro; Okamoto, Michio; Yamamoto, Kōji

doi:10.1016/j.otsr.2015.04.003

Cited by 18 publications

(11 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Arthroscopy has been recently used as a diagnostic tool in this regard. 14 In case the cartilage was disrupted, an arthrotomy was performed for reduction and fixation. lt seems that magnetic resonance imaging can accurately provide the same information noninvasively.…”

Section: Salter Harris Type Ill and IV Fracturesmentioning

confidence: 99%

Arthroscopic Treatment of Pediatric Fractures

Accadbled

N’Dele

2018

Journal of Pediatric Orthopaedics

View full text Add to dashboard Cite

Management of pediatric articular fractures has evolved over the years with a growing interest in arthroscopic handling. Several factors account for this recent appeal among which are progress in technology with increased availability of diagnostic methods, rise in athletic activities responsible for these fractures, and pediatric orthopaedic surgeons getting familiar with arthroscopic techniques. In our institution, 9 of 100 arthroscopic procedures are performed as a consequence of an articular fracture. In total, 80% of the fractures concern the knee (56% of tibial eminence fracture, 24% osteochondral fracture). Most of the remaining 20% are located at the ankle joint. Given the thorough articular exploration that arthroscopy provides, any associated cartilaginous or meniscal lesions is identified and addressed in the same procedure as the fracture fixation. Being a less invasive surgery with low complication rate, arthroscopic management of pediatric articular fractures provides very satisfactory results with earlier recovery. Of note, it is technically demanding and requires constant training. The operative time should be monitored and alternative options considered for each surgery. In this regard, arthroscopy has to be viewed as a means not an end.

show abstract

Section: Salter Harris Type Ill and IV Fracturesmentioning

confidence: 99%

Arthroscopic Treatment of Pediatric Fractures

Accadbled

N’Dele

2018

Journal of Pediatric Orthopaedics

View full text Add to dashboard Cite

show abstract

“…Standard radiography has limitations in showing the epiphyseal cartilage of the distal humerus in children. Magnetic resonance imaging (MRI) [6,7] or arthroscopy [8,9] can assess the integrity of the articular cartilage, but the former method requires sedation. It is difficult for children to cooperate during the examination, so arthroscopy requires general anesthesia.…”

Section: Introductionmentioning

confidence: 99%

Determining the stability of minimally displaced lateral humeral condyle fractures in children: ultrasound is better than arthrography

Shao-wei

et al. 2021

J Orthop Surg Res

View full text Add to dashboard Cite

Background Evaluating of the articular cartilage status of the distal humeral epiphysis is difficult. Ultrasound imaging of the elbow is increasingly being used to confirm the integrity of the articular cartilage of minimally displaced lateral humeral condyle fractures in children with minimally displaced fractures. The aims of this study were to assess the correlations between ultrasound and arthrography findings for predicting the integrity of the cartilage hinge and to describe the utility of ultrasound in determining the need for pre-treatment. Methods Thirty-nine patients with minimally displaced lateral humeral condyle fractures who underwent ultrasound and arthrography examinations before surgery from May 2018 to December 2019 were included in this study. Ultrasound and arthrography predictors of the cartilage hinge status were independently measured. The ultrasound and arthrography results were compared. Results The mean displacement of the fractures was 3.1 mm (range, 2.0~5.0 mm). Arthrography showed incomplete fractures in 24 patients (61.5%) and complete fractures in 15 patients (38.5%). Ultrasound showed incomplete fractures in 25 patients (64.1%) and complete fractures in 14 patients (35.9%). The ultrasound and arthrography results of the integrity of the articular surface were consistent in 92.3% of the cases, including 23 that were predicted to have an intact articular surface and 13 that were predicted to have an incongruity articular surface. There was no correlation between the displacement and the fracture appearing complete on the ultrasound scan. The Pearson coefficient between ultrasound and arthrography for assessing the integrity of the articular surface was 0.837. Conclusions Ultrasound and arthrography assessments of the integrity of the cartilage hinge status appear to be highly consistent. Ultrasound can be used as a complementary tool with arthrography to predict the integrity of the cartilage hinge status in children with minimally displaced lateral humeral condyle fractures. Level of evidence Prospective study; level II.

show abstract

“…For the fracture with small displacement, conservative or surgical treatment is chosen, mainly based on the stability of the fracture, the existence of articular cartilage hinges determines the stability of LCF. 9 Therefore, for micro-displaced fractures whose stability can not be completely judged by X-ray lms, it is suggested that the integrity of articular cartilage hinges can be judged by elbow arthrography, 10 or the articular surface can be detected by arthroscopy, so as to determine whether cartilage hinges are broken or not, so as to avoid missed diagnosis and mistreatment of micro-displaced LCF in children. 9 There are also multicenter studies in China that LCF with displacement ≤ 2mm is prone to re-displacement.…”

Section: Selection Of Surgical Indications and Surgical Methodsmentioning

confidence: 99%

A retrospective comparative study of open reduction and cannulated screw fixation and Kirschner wire fixation in the treatment of fracture of lateral condyle of humerus in children

Luo¹,

Chen²,

Wang³

2021

Preprint

View full text Add to dashboard Cite

Objective To evaluate the clinical efficacy of two surgical methods in the treatment of fracture of lateral condyle of humerus in children and the application value of two kinds of internal fixation materials.Methods A total of 32 children with fracture of lateral condyle of humerus were treated in our hospital from June 2015 to June 2018, with an average age of 5.6 years, including 18 males and 14 females. The patients were divided into two groups: group A (n = 12) and group B (n = 20). By comparing the operation time, removal of internal fixation time, Dhillon elbow function evaluation, HHS elbow function score, X-ray measurement of postoperative carrying angle, Baumann angle and distal humerus anteversion angle, the operation-related complications were recorded in detail.Results The operation time was 0.9 ±0.2 hours in group A, 0.8 ±0.2 hours in group B, P > 0.05. The removal internal fixation time was 91 ±8 days in group A, 59 ±10 days in group B (P < 0.05). The Dhillon elbow function score was 8.2 ±0.6 in group A, 8.0 ±0.8 in group B, and 93 ±5 in group A and 89 ±4 in group B (P > 0.05). The carrying angle was 10 °±1 °in group A and 10 °±2 °in group B (P > 0.05). The Baumann angle was 15 °±4 °in group A and 16 °±3 °in group B (P > 0.05). The anteversion of distal humerus was 33 °±3 °in group A and 33 °±4 °in group B (P > 0.05). In the last follow-up, the excellent and good rate of elbow joint function in group A was excellent in 8 cases and good in 4 cases, and the excellent and good rate in group B was 100%. In group B, 13 cases were excellent, 6 cases were good, and 1 case was moderate, with an excellent and good rate of 95%. The postoperative complications were observed in group A, including avascular necrosis of lateral condyle in 1 case, premature closure of epiphysis in 1 case, skin irritation in 5 cases, needle exudation and incision infection in 2 cases, hyperplasia of lateral condyle in 3 cases, and loss of extension and flexion in 1 case.Conclusions There was no significant difference in operation time, elbow function recovery and imaging measurement between the two surgical methods in the treatment of lateral condylar fracture of humerus. Kirschner wire group had a certain advantage over cannulated cancellus screw group in fracture healing and removal of internal fixation. however, the clinical observation screw group has advantages in postoperative nursing and early exercise.

show abstract

Diagnostic arthroscopy in the treatment of minimally displaced lateral humeral condyle fractures in children

Abstract: Level IV, therapeutic case series.

Cited by 18 publications

References 20 publications

Arthroscopic Treatment of Pediatric Fractures

Arthroscopic Treatment of Pediatric Fractures

Determining the stability of minimally displaced lateral humeral condyle fractures in children: ultrasound is better than arthrography

A retrospective comparative study of open reduction and cannulated screw fixation and Kirschner wire fixation in the treatment of fracture of lateral condyle of humerus in children

Contact Info

Product

Resources

About