Neural injuries associated with supracondylar fractures of the humerus in children.

Culp, Randall W.; Osterman, A. Lee; Davidson, Richard S.; Skirven, Terri M.; Bora, F. William

doi:10.2106/00004623-199072080-00013

Cited by 132 publications

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“…In our study it has been found that fall while playing and fall from bicycle causes maximum injury in the early group which is 33.33% while in the late group it was found that fall while playing causes maximum injury which is 42.1%, which is consistent with other studies [35][36][37][38][39] . In our study it was found that radial nerve was the commonest nerve involved, although slightly higher than described in the literature in early group (14.8%) and median nerve palsy (7.4%), while patients presenting late had no such complications [43][44] . In our study none of the patients had ulnar nerve injury at the time of presenting to the hospital, and none had similar complains in the postoperative period.…”

Section: Discussioncontrasting

confidence: 53%

Untitled

2017

Int. J. Orthop. Sci.

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Purpose: Controversy still persists regarding optimum intervention time for late presentations of supracondylar fracture of humerus in children. We compared outcomes in early and late groups of presentation and management. Study design: We conducted prospective study comparing early and late open reduction and Kirschner wire fixation for Gartland type III supracondylar fracture of humerus in children aged less than 16 years. We analyzed results of 27 cases in early group and 19(8 lost) cases in late group. We compared duration of surgery, range of motion, and Flynn's criteria were used to evaluate outcome. Results: Thirty (65%) patients were male and 15(32.60%) had dominant limb involvement. Injury to surgery time was 53.63±41.03 hours in early group and 338.53±134.31 hours in late group (p<0.005). Pre-operative nerve injury was 6(13%) cases in early group. Bauman's angle at 12 weeks in early group was 70.04± 3.240 & in late group had71.42± 8.329. (p< 0.513). Loss of range of motion between groups was insignificant (p< 0.668). According to Flynn's, results were comparable between groups. Conclusion: We concludes that in cases of Garland type III supracondylar fracture of humerus of children open reduction & k-wire fixation is an effective method of treatment in both groups.

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Section: Discussioncontrasting

confidence: 53%

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2017

Int. J. Orthop. Sci.

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“…Brachial artery lesion may be secondary to various insults, such as entrapment, division, spasm of the vessel, the presence of an intimal tear or thrombus formation. On the other hand, the relative incidence of nerve injuries has been reported as being 12-20% [3,7] and they mainly (86-100%) consist of neurapraxias, which usually resolve spontaneously [2,3,20].…”

Section: Introductionmentioning

confidence: 99%

Treatment of pink pulseless hand following supracondylar fractures of the humerus in children

Korompilias

Lykissas

Mitsionis

et al. 2008

International Orthopaedics (SICO

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Although acute vascular injury is a common complication in children with severely displaced supracondylar humeral fractures, the management of patients with a pink pulseless hand still remains controversial. Between 1994 and 2006, 66 children with displaced supracondylar fractures of the humerus were treated. Five patients had an absence of the radial pulse with an otherwise well perfused hand. In one patient, radial pulse returned after closed reduction of the fracture. In four patients, open reduction and vascular exploration was required. Three patients had brachial artery occlusion because of thrombus formation. Thrombectomy was performed, which led to the restoration of a palpable radial pulse. In one patient with open fracture, brachial artery contusion and spasm were found, and treated by removal of adventitia. Surgical exploration for the restoration of brachial artery patency should be performed, even in the presence of viable pink hand after an attempt at closed reduction.Résumé Au cours d'une fracture supra condylienne du coude déplacée, les complications vasculaires sont relativement fréquentes. Le traitement, lui aussi, est largement controversé, notamment lorsqu'il existe une absence de pouls radial après la fracture. Entre 1994 et 2006, 66 enfants présentant une fracture supra condylienne du coude ont été traités. 5 présentaient une complication vasculaire avec absence de pouls radial. Chez un des patients, le pouls radial est réapparu après réduction à foyer fermé. Chez les 4 autres patients, il a été nécessaire de faire une réduction sanglante avec exploration vasculaire. 3 des patients avaient une occlusion de l'artère humérale. La thrombectomie a été réalisée avec restauration du pouls radial. Sur un patient, il s'agissait d'une contusion de l'artère brachiale avec spasme et une réapparition du pouls après endar térectomie. L'exploration vasculaire chirurgicale doit être réalisée même si la main se recolore après une réduction à foyer fermé.

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“…kapalı redüksiyon ve perkütan çivileme ile ameliyat edilen 52 olgunun %18'inde vasküler, %13'ünde nöronal komplikasyon bildirmişlerdir [10]. Yine bazı kaynaklarda perkütan çivi-leme sonrasında oluşan sinir yaralanmalarının oranı %7 ile %16 arasında bildirilmiştir [27,28] …”

Section: Sonuçlarunclassified

The Effects of Surgical Treatment on Elbow and Hand Functions in Gartland Type 3 Children’s Humerus Supracondylar Fractures with Posterior Approach

Seyfettinoğlu¹

2015

Ann Clin Anal Med

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ÖzetAmaç: Bu çalışmada açık cerrahi yöntemle tedavi edilen Gartland tip 3 çocuk humerus suprakondiler kırığı olan hastalarda;cerrahi tedavinin dirsek ve el iş-levleri üzerindeki etkilerinin değerlendirilmesi amaçlandı. Gereç ve Yöntem: 2005Yöntem: -2009 Yıllarında kliniğimizde tedavi edilen ve düzenli takibi yapılabilen 25 hasta (7K/18E; ortalama yaş 6,7 dağılım:3-13) çalışmaya dahil edildi. Kı-rıkların hepsi Gartland sınıflamasına göre göre ekstansiyon tip 3 kırıktı. Bütün hastalara posterior yolla açık redüksiyon ve internal tespit yapıldı. Yirmi hasta ilk 8 saat içinde, 5 hasta ise 8-72. saatler arasında (ortalama 57,6 saat) ameliyat edildi.Ameliyat sonrası izlemlerde hastaların taşıma açısı, dirsek hareket açıklığı ve el değerlendirme testleri ile el kavrama gücü ve çimdikleme gücü ölçüldü. Q-DASH skorlama sistemi ile üst ekstremite fonksiyonları puanlandı.Flynn kriterlerine göre fonksiyonel ve kozmetik sonuçlar değerlendirildi. Ortalama izlem süresi 32 aydı. Bulgular: Flynn kriterlerine göre 25 hastadan fonksiyonel olarak 20'sinde mükemmel, 1'inde iyi, 3'ünde orta, 1'inde kötü sonuç alındı.Son kontrolde 6 hastada (%24) ortalama 3.9° (min 5° -max 25°) fleksiyon kısıtlılığı mevcuttu. Hastaların hiçbirinde son kontrol muayenelerinde ekstansiyon kısıtlılığı görülmedi.Sağlam tarafla kıyaslama sonrası elde ortalama 0.9 kg (%4) kavrama gücü kaybı mevcutken, ortalama 0,05 kg (%0.8) çimdikleme gücü kaybı saptandı. Sağlam dirsekle kıyaslama sonrası hastaların 16 (%60) sında ortalama 2.1º(min -10° -max +5°) taşıma açısı kaybı mevcuttu.Bunlardan 3 tanesi valgus yönünde (ort 3.6°,min+3°-max+5° ),12 tanesi varus yönünde (ort 5.7°, min -10° -max -3°) kayıp mevcut iken 10 hastada taşıma açısı kaybına rastlanmadı. Tartışma:Posterior girişimin en önemli dezavantajı olarak görülen ekstansiyon kısıtlılığı ve triceps yetmezliğinin son kontrolde tamamen düzeldiği gözlendi. Çocuk humerus suprakondiler kırıklar-da tedavi sonrası gelişen taşıma açısı kaybının fonksiyonel sonuçları anlamlı düzeyde etkilemediği sonucuna varıldı. Anahtar KelimelerÇocuk; Suprakondiler Humerus Kırığı; Posterior Yaklaşım Abstract Aim: The aim of this study was to evaluate the effects of treatment with open surgery methods on elbow and hand functions in paediatric patients with a Gartland Type 3 humerus supracondylar fracture. Material and Method: The study comprised 25 patients (7 female, 18 male; mean age 6.7 years, range, 3-13 years) who were treated and regularly followed up at our clinic between 2005 and 2009. All the fractures were extension Type 3 according to the Gartland classification. All the patients were treated with posterior approach open reduction and internal fixation. 20 patients underwent surgery within the first 8 hours and 5 patients between 8-72 hours (mean 57.6 hours). In the postoperative follow-up, carrying angle, elbow range of movement, grip strength and pinch strength were measured with hand evaluation tests. Upper extremity functions were scored with the Q-DASH scoring system. The functional and cosmetic results were evalua...

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Neural injuries associated with supracondylar fractures of the humerus in children.

Cited by 132 publications

References 0 publications

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Treatment of pink pulseless hand following supracondylar fractures of the humerus in children

The Effects of Surgical Treatment on Elbow and Hand Functions in Gartland Type 3 Children’s Humerus Supracondylar Fractures with Posterior Approach

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