Percutaneous fixation of supracondylar fractures of the humerus in children

Arino, VL; Lluch, E E; Ramirez, AM; Ferrer, Jesús; Rodríguez, Luis López; Baixauli, Francisco Raga

doi:10.2106/00004623-197759070-00013

Cited by 125 publications

(62 citation statements)

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“…In literature, Arino et al reported that it was almost 21%, ulnar nerve deficit. 12 In other study it was found in 15% of patients who were treated with medial and lateral pin as per the report of Chai. 13 Sankar et al studied the loss of pin fixation in supracondylar fractures.…”

Section: Discussionmentioning

confidence: 65%

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Cross pinning versus lateral pinning in type III supracondylar fracture: a retrospective analysis

Govindasamy

Gnanasundaram²,

Kasirajan

et al. 2016

Int J Res Orthop

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Background: The commonly accepted treatment of type III supracondylar fractures of humerus in children is closed reduction percutaneous pinning (CRPP). There is a long debate over stability and complications associated with cross and lateral pinning. The present study compares the functional outcome and complications of both pinning techniques.Methods: A retrospective analysis of results with regard to ulnar nerve injury, carrying angle and range of movements was made in 27 children with lateral pinning and 28 children with crossed pinning was done in our institution. Functional outcome was graded according to Flynn’s criteria and loss of reduction by Skagg’s criteria.Results: There was no statistically significant difference with regard to functional outcome and loss of reduction between the two groups. Iatrogenic ulnar nerve injury (IUNI) occurred in three cases (11%) after crossed pinning in which two had significant palsy, which recovered by three months and the other had only transient paraesthesia.Conclusions: Lateral pinning technique is reliably safe method in terms of stability as it avoids IUNI, we recommend it.

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Section: Discussionmentioning

confidence: 65%

“…8,10,11 Arino and skaggs et al used lateral pins. 9,12 The goal of all forms of treatment is the same, to obtain and maintain an anatomic reduction of the distal humerus to minimize complications such as nerve injury, compartment syndrome, Volkmann ischaemic contracture, cubitus varus deformity and limitation of elbow movements.…”

Section: Discussionmentioning

confidence: 99%

Cross pinning versus lateral pinning in type III supracondylar fracture: a retrospective analysis

Govindasamy

Gnanasundaram²,

Kasirajan

et al. 2016

Int J Res Orthop

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“…L. Areno et. al (11) treated 189 patients with closed percutaneous pinning had satisfactory results of 85%. In 1987 Aronson and prager (4) treated 20 patients with closed reduction and percutaneous pinning, all had excellent or good results.…”

Section: Resultsmentioning

confidence: 99%

Management of Displaced Supracondylar Fractures of the Humerus in Children by Closed Reduction and Percutaneous Pinning

Srinivas¹,

Jagadish²,

Mahesh³

2015

jemds

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INTRODUCTION: Supracondylar fracture of the humerus is common injury in children between the ages of 5 to 10 years. With males are affected twice high than females. The average age incidence was 8.3 years. Proper clinical and radiological examination is necessary for type of displacement and type of treatment. Percutaneous pinning of supracondylar fracture is certainly not a new technique (5), but it had excellent results in various series, comparatively with other techniques. Closed reduction and crossed percutaneous pinning is a reliable method of treatment for severely displaced supracondylar fractures of the humerus in children. MATERIALS: In our study 25 patients were treated with closed reduction and percutaneous pinning between 2009-2014. All 25 fractures were extension type III and closed variety. Left side was involved in 20 patients and Right side in 5 patients. The commonest mode of injury was by fall while playing and fall from bicyle. The displacement of the fracture was posteromedial in 19 patients and posterolateral in 6 patients. RESULTS: In our study we had 84% excellent or good results and 16% fair or poor results. Results were assessed according to the flynn's criteria. We had following complications after percutaneous pinning. In one patient ulnar neuropraxia developed because of the medial pin. After 1 week medial pin was removed and following that patient recovered completely. In our study one patient had radial and median nerve injury and developed myositis ossificans. Mild degree of volkmann's ischaemia and restriction of elbow movements. All these were because of the patient had massage and manipulation elsewhere before the treatment. Another patient had mild degree of cubitus varus deformity. DISCUSSION: Closed reduction with immobilization in cast and Dunlop's traction, skeletal traction necessitates either longer duration of hospitalization or supervision of the patient constantly. Open reduction and internal fixation always have the chance of infection and risk of myositis ossificans and associated loss of motion. CONCLUSION: Closed reduction and percutaneous pinning under image intensifier control offers several advantages such as accurate anatomic reduction, good stabilization, and early mobilization, less chances of joint stiffness and with low rate of malunion. And the hospital stay is shorter (5).

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“…3)에서 바우만 각 19) , 골간단-골간 각 4) , 내상과-골단 각 1,11,14) . 내측 핀 삽입 시 합병 될 수 있는 척골 신경 손상을 막기 위해 외측에만 2개의 핀 고정 1) 을 주장한 바도 있었으나 외측 2개의 핀 고정과 함께 내측 핀 고정을 시행하여 확고한 안정성을 얻을 수 있는 방법 또한 안전함이 입증된 바 있다 14) . 따라서 본 연 구에서는 4∼12세의 소아 환아를 대상으로 하였으며 Gartland …”

Section: 서 론unclassified

Reliability of the Radiographic Parameters in Pediatric Supracondylar Fracture

2010

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Purpose: To suggest the most reliable guideline of the treatement for the supracondylar fracture in children by the comparison of the radiographic parameters between forearm supination-elbow extension and forearm pronation-elbow flexion view. Materials and Methods: A total of seventy-one patients were included in the study. Baumann, metaphyseal diaphyseal and medial epicondylar epiphyseal angle of normal elbow in extension and flexion view were compared. Finally, the results of Group I (operation with elbow extension view) and Group II (operation with elbow flexion view) were compared. Results: Intraobserver reproducibility and interobserver reliability were better in the Baumann angle with extension view and metaphyseal diaphyseal angle with flexion view. In extension view, Baumann and metaphyseal diaphyseal angle show negative correlation with carrying angle but in flexion view, only metaphyseal diaphyseal angle shows negative correlation. Baumann angle were greater in flexion view and medial epicondylar epiphyseal angle were greater in extension view. There was no statistical difference in the final results of Group I and II. Conclusion: Baumann angle was more effective in forearm supination-elbow extension view and metaphyseal diaphyseal angle was more effective in forearm pronation-elbow flexion view. The difference between elbow extension and flexion view should be considered during operation.

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Percutaneous fixation of supracondylar fractures of the humerus in children

Cited by 125 publications

References 0 publications

Cross pinning versus lateral pinning in type III supracondylar fracture: a retrospective analysis

Cross pinning versus lateral pinning in type III supracondylar fracture: a retrospective analysis

Management of Displaced Supracondylar Fractures of the Humerus in Children by Closed Reduction and Percutaneous Pinning

Reliability of the Radiographic Parameters in Pediatric Supracondylar Fracture

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