Flexion type supracondylar humerus fractures: 12 year experience of a pediatric orthopedics clinic

Turgut, Ali; Kalenderer, Önder; Bozoglan, Muhammet; Bacaksız, Tayfun; Ağuş, Haluk

doi:10.5606/ehc.2015.31

Cited by 18 publications

(17 citation statements)

References 13 publications

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“…Flexion-type supracondylar fractures have been associated with more short-term and long-term complications and a high rate of open reduction [11,12]. According to Kuoppala et al, flexion-type fractures are prone to more displacement; they report only 1 non-displaced flexion-type SHF out of 7 [11].…”

Section: Discussionmentioning

confidence: 99%

Flexion-Type Supracondylar Humeral Fracture with Ulnar Nerve Injury in Children: Two Case Reports and Review of the Literature

et al. 2020

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Rare co-existance of disease or pathology Background: Supracondylar humeral fracture is a common fracture in the pediatric population. Although extension-type is the most common fracture pattern (97% to 98%), flexion-type supracondylar fractures are rarely encountered (2% to 3%). The combination of a flexion-type supracondylar humeral fracture with an ulnar nerve injury represents a real challenge for an orthopaedic surgeon. Case Reports: We report 2 cases of flexion-type supracondylar humeral fracture with ulnar nerve injury that open reduction and fixation was necessary because closed reduction could not achieve an acceptable result. An anterior approach to the elbow joint was chosen to explore whether any neurovascular structures were entrapped between the fragments. The ulnar nerve was not found to be compressed in the fracture site. After anatomic reduction, cross K-wire fixation of the fracture was performed. At 6-month follow-up, ulnar nerve injuries (in both patients) were resolved. Conclusions: These case reports enhance the existing literature that flexion-type supracondylar fractures with ulnar nerve injury are associated with higher rates of open reduction. Orthopaedic surgeons should be aware, and family members of those patients should be informed, that the likelihood of an open reduction in these types of injuries is extremely high. Open reduction is needed not only to achieve an anatomic reduction of the fracture but to make sure that the ulnar nerve is not entrapped between the proximal and distal fragment.

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Section: Discussionmentioning

confidence: 99%

Flexion-Type Supracondylar Humeral Fracture with Ulnar Nerve Injury in Children: Two Case Reports and Review of the Literature

et al. 2020

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“…[1,2] The incidence of radial nerve injuries with humerus fractures has been documented to be between 2% to 25%. [3,4] The nerve may be injured due to contusion, laceration, traction or entrapment between the fracture fragments.…”

Section: Objectivesmentioning

confidence: 99%

Humeral shaft fractures and radial nerve palsy: early exploration findings

Yörükoğlu

Demirkan

Büker

et al. 2016

Eklem Hastalik Cerrahisi

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ÖZAmaç: Bu yazıda humerus cisim kırığıyla birliktelik gösteren radial sinir felçli olgularda erken dönem sinir eksplorasyonunun sonuçları sunuldu ve hangi olgularda erken sinir eksplorasyonunun faydalı olabileceği araştırıldı. Hastalar ve yöntemler: Humerus cisim kırığına eşlik eden tam duyu ve motor radial sinir hasarı olan 24 hasta (17 erkek, 7 kadın; ort. yaş 36 yıl; dağılım 18-72 yıl) retrospektif olarak incelendi. Yüksek enerjili travmalı hastalar ile spiral ve parçalı kırığı olan düşük enerjili travmalı hastalar çalışmaya alındı. Tüm hastalara sinir eksplorasyonu kırık oluşumu sonrası ortalama 4.8 günde (dağılım 1-20 gün) uygulandı. On ikinci haftaya kadar nörolojik iyileşme olmayan hastalara elektrofizyolojik değerlendirmeler uygulandı. Bulgular: Ameliyat edilen 24 hastanın 14'ünde (%58.3) görülen spiral humerus cisim kırıkları en yaygın kırık tipi idi; bunu dört hastada transvers (%16.6) ve iki hastada (%8.3) parçalı kırık izledi. Eksplorasyon sonucu yedi hastada (%29.1) sinirin kırık fragmanları arasında sıkışmış olduğu görüldü; bu hastaların çoğunluğu (n=6) spiral humerus kırıklı idi, bir hastada ise parçalı kırık vardı. Spiral tip kırığı olan bir hastada sinir transeksiyonu vardı. Hastaların çoğunluğunda (%95.8) radial sinir fonksiyonları iyileşti. Kırık kaynama süresi ortalama 6.7±3.8 ay (dağılım 3-18 ay) idi. Sonuç: Spiral humerus kırıkları, özellikle kama fragmanlı olanlar, erken cerrahi eksplorasyon için aday olabilir. Erken dönem eksplorasyonu spiral ve parçalı humerus kırığına eşlik eden radial sinir disfonksiyonlu hastalarda sinir hasarının erken saptanması açısından faydalı olabilir.Anahtar sözcükler: Humerus kırığı, sinir ezilmesi, periferik sinir hasarları, radial nöropati. ABSTRACTObjectives: This study aims to present the results of early nerve explorations in cases with radial nerve palsy associated with humeral shaft fracture and to investigate in which cases early nerve explorations may be beneficial. Patients and methods: Twenty-four patients (17 males, 7 females; mean age 36 years; range 18 to 72 years) with complete sensory and motor radial nerve damage associated with humeral shaft fracture were retrospectively analyzed. The patients with high-energy trauma and the ones who had spiral and segmental fractures with low energy traumas were included in the study. Early nerve exploration was performed in all patients within an average of 4.8 days (range 1 to 20 days) after fracture development. Electrophysiological assessments were performed in cases with no neurological recovery until 12 th week.Results: Spiral fractures of the humerus shaft observed in 14 (58.3%) of the 24 operated patients were the most common fracture type, followed by transverse fracture in four patients (16.6%) and comminuted fracture in two patients (8.3%). As a result of the exploration, we observed nerve compression between the fracture fragments in seven patients (29.1%); a majority of these patients (n=6) had spiral fractures of humerus and one patient had comminuted fracture. One patient with a spiral type fr...

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“…Surgical treatment is preferred in children with multiple injuries, in open fractures, in some pathologic fractures, in fractures with coexisting vascular injuries, in fractures which have a history of failed initial conservative treatment, in fractures in which the conservative treatment has no/little value such as femur neck fractures, some physeal fractures, displaced extension and flexion type humerus supracondylar fractures, displaced humerus lateral condyle fractures, femur, tibia and forearm shaft fractures in older children and adolescents and unstable pelvis and acetabulum fractures. [6,7,11,14,15] Basic Treatment Principles According to the Type of the Fracture…”

Section: Goals Of Fracture Treatment In Childrenmentioning

confidence: 99%

Basic principles of fracture treatment in children

Ömeroğlu¹

2018

Eklem Hastalik Cerrahisi

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This review aims to summarize the basic treatment principles of fractures according to their types and general management principles of special conditions including physeal fractures, multiple fractures, open fractures, and pathologic fractures in children. Definition of the fracture is needed for better understanding the injury mechanism, planning a proper treatment strategy, and estimating the prognosis. As the healing process is less complicated, remodeling capacity is higher and non-union is rare, the fractures in children are commonly treated by non-surgical methods. Surgical treatment is preferred in children with multiple injuries, in open fractures, in some pathologic fractures, in fractures with coexisting vascular injuries, in fractures which have a history of failed initial conservative treatment and in fractures in which the conservative treatment has no/little value such as femur neck fractures, some physeal fractures, displaced extension and flexion type humerus supracondylar fractures, displaced humerus lateral condyle fractures, femur, tibia and forearm shaft fractures in older children and adolescents and unstable pelvis and acetabulum fractures. Most of the fractures in children can successfully be treated by non-surgical methods.

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Flexion type supracondylar humerus fractures: 12 year experience of a pediatric orthopedics clinic

Abstract: ÖZ Amaç

Cited by 18 publications

References 13 publications

Flexion-Type Supracondylar Humeral Fracture with Ulnar Nerve Injury in Children: Two Case Reports and Review of the Literature

Flexion-Type Supracondylar Humeral Fracture with Ulnar Nerve Injury in Children: Two Case Reports and Review of the Literature

Humeral shaft fractures and radial nerve palsy: early exploration findings

Basic principles of fracture treatment in children

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