Open Reduction of Displaced Pediatric Supracondylar Humeral Fractures Through the Anterior Cubital Approach

Ay, Şadan; Akinci, Metin; Kamiloglu, Sinan; Erçetin, Ömer

doi:10.1097/01.bpo.0000153725.16113.ab

Cited by 50 publications

(31 citation statements)

References 15 publications

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“…The proximity to structures liable to traumatic lesions was an advantage as exposure of the fracture line facilitated protection of these structures. We have not seen any serious dislodgement into the fracture in this series, but it was reported in another case series [2]. The skin incision has always healed without any problems and the last result showed a very cosmetically satisfactory scar.…”

Section: Discussionmentioning

confidence: 69%

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Treatment of supracondylar fractures of the humerus in children through an anterior approach is a safe and effective method

Ersan

Gönen

Arık

et al. 2008

International Orthopaedics (SICOT)

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In this prospective case series we evaluated the effectiveness and safety of using an anterior approach to paediatric supracondylar humerus fractures. We gathered data on 46 children that had a displaced supracondylar fracture of the humerus. All the patients had sustained a Gartland type III extension fracture that could not be reduced by closed means. Open reduction through an anterior approach was performed and two Kirschner wires were used to fix the fracture to the medial and lateral sides. Patients were recalled for follow-up and were evaluated using Flynn's radiological and clinical criteria. Loss of extension and flexion was noted by clinical assessment and carrying angle measured on radiograms. A follow-up examination performed in the 24th postoperative week showed that all fractures had healed; the patients' outcomes were rated as excellent or good according to Flynn's criteria. As a result the anterior approach for open reduction of paediatric supracondylar humeral fractures is a safe and reliable method with very good results.

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Section: Discussionmentioning

confidence: 69%

“…Also a few articles have been published regarding its use [1,2]. This article is the first relating its use in a teaching environment.…”

Section: Discussionmentioning

confidence: 99%

Treatment of supracondylar fractures of the humerus in children through an anterior approach is a safe and effective method

Ersan

Gönen

Arık

et al. 2008

International Orthopaedics (SICOT)

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“…The levels of evidence of these studies were II (prospective comparative study) [2], III (retrospective comparative study) [1,7], and IV (case series) [21,26,35,39]. Two hundred and twenty-six patients were included for the final analysis.…”

Section: Methodsmentioning

confidence: 99%

“…Two hundred and twenty-six patients were included for the final analysis. Patients were distributed into the different surgical approaches as follows: lateral (58) [2,7,21], medial (50) [21,26,39], posterior (47) [1,21,26], anterior (65) [35,39], and medial ? lateral (6) [21,26,39].…”

Section: Methodsmentioning

confidence: 99%

Surgical approaches for open reduction and pinning in severely displaced supracondylar humerus fractures in children: A systematic review

Mazzini

Martín

Esteban

2010

Journal of Children's Orthopaedics

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Purpose There is no clear evidence in the actual literature regarding which of the surgical approaches could bring about the best functional, cosmetic, and radiological outcomes, as well as fewer complications, when an open reduction and pinning of a severely displaced supracondylar humerus fracture is performed. We, therefore, performed a systematic review of the English literature to investigate the existing evidence regarding this issue. Methods A MEDLINE and EMBASE databases search was performed to identify articles that focused on the functional, cosmetic, and radiological outcomes, as well as post-surgical complications, regarding different surgical approaches used for open reduction and pinning in severely displaced supracondylar humerus fractures in children. One hundred and ninety-four articles were identified, of which seven were included for review. Data analysis included weighted means for all contingency tables and the Chi-square test. Standardized residues were studied when the Chi-square test was statistically significant. Statistical analyses were conducted using Stata 9.1/SE (StataCorp., College Station, TX) and P-values lower than 0.05 were considered to be statistically significant for all analyses. Results For functional outcome, a high frequency of excellent results was found within the lateral and medial approaches, and a high frequency of good results within the anterior approach. A high frequency of poor results was found within the posterior approach. For cosmetic outcome, there was a high frequency of fair results within the posterior and lateral approaches, and a high frequency of poor results within the posterior approach. No statistically significant difference regarding time to union, as well as complications, was found. Conclusion Our results suggest that a combined anteromedial approach could be the method which allows the achievement of better functional and cosmetic outcome according to Flynn's criteria. Time to union, as well as post-surgical complications, should not be an issue regarding surgical approaches used for open reduction and pinning in these fractures.

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“…There is no clear evidence in the literature regarding which of the surgical approaches brings about the best outcomes as well as minimizing complications. 9,11 We prospectively evaluated the results of very late open reduction of 8 malunited paediatric supracondylar humeral fractures using inverted V-Y tricepsplasty approach and callus osteoclasis (Calloclasis).…”

Section: Introductionmentioning

confidence: 99%

Open Reduction and K - Wire Fixation of Very Late Presenting Paediatric Suprasupra Condylar Humeral Fractures Using Inverted v - Y Tricepsplasty Approach and Callus Osteoclasis

Singh¹,

Chaurasia²,

Lakhtakia³

2015

jemds

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BACKGROUNDFracture supracondylar humerus is a common paediatric injury. The current preferred treatment option for the displaced supracondylar fracture is early closed reduction and percutaneous pinning. Neglected displaced fractures of supracondylar humerus are not uncommon in developing countries like India. We prospectively evaluated the results of early correction of 8 malunited paediatric supracondylar humeral fractures using inverted V-Y tricepsplasty approach and callus osteoclasis (Calloclasis). MATERIAL AND METHODSThis prospective study included 10 extension type malunited paediatric supracondylar fractures that were operated from July 2012 to June 2014. Exposure of the distal humerus was done using inverted V-Y tricepsplasty approach. The entire callus tissue was circumferential removal, anatomic reduction of the displaced bony fragments was achieved and then fixation with two Kirschner wires was done. K-wires were removed at around 4 th week postoperatively and patients were followed up monthly up to the 6 months. RESULTSAll fractures united in a mean duration of 7.4 weeks. At last follow-up after 5 months on average, 7 (87.5%) patients had satisfactory outcomes. Iatrogenic ulnar neuropraxia was found in 1 patient and restricted range of motion was noted in 1 patient. CONCLUSIONThe advantages of V-Y tricepsplasty approach is that it is simple and allows doing a circumferential callus osteoclasis, which helps in reducing and fixing the fracture under direct visual control. The disadvantage of this approach is that it is associated with more postoperative pain and requires prolonged triceps rehabilitation.

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Open Reduction of Displaced Pediatric Supracondylar Humeral Fractures Through the Anterior Cubital Approach

Cited by 50 publications

References 15 publications

Treatment of supracondylar fractures of the humerus in children through an anterior approach is a safe and effective method

Treatment of supracondylar fractures of the humerus in children through an anterior approach is a safe and effective method

Surgical approaches for open reduction and pinning in severely displaced supracondylar humerus fractures in children: A systematic review

Open Reduction and K - Wire Fixation of Very Late Presenting Paediatric Suprasupra Condylar Humeral Fractures Using Inverted v - Y Tricepsplasty Approach and Callus Osteoclasis

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