Ultrasonography of the pediatric elbow

Averill, Lauren W.; Kraft, Denver; Sabado, Jeremiah J; Atanda, Alfred; Long, Suzanne S.; Nazarian, Levon N.

doi:10.1007/s00247-023-05623-8

Cited by 3 publications

(5 citation statements)

References 43 publications

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“…Nonetheless, the evaluation criteria for HLCFs require further large-scale multicenter studies to confirm their clinical feasibility. In terms of complications, compared with other UG-CRPP studies, no increase in either the surgical time or the incidence of postoperative complications was found in this study (13)(14)(15)(16)(17)(18)(19). One patient, a young toddler possibly presenting with a less stable fixation, exhibited mild re-displacement after surgery.…”

Section: Discussioncontrasting

confidence: 60%

“…Although UG-CRPP techniques have become popular, there are currently no definite probe positions or corresponding imaging criteria indicative of successful outcomes (13)(14)(15)(16)(17)(18)(19). This study describes the probe position of UG-CRPP in four scans: (i) coronal plane parallel articular surface scanning to evaluate the lateral and anteroposterior displacement of the cartilage hinge, (ii) coronal plane vertical articular surface scanning to evaluate the anteroposterior displacement of the fragment and capitellum-radial alignment, (iii) sagittal plane vertical articular surface to evaluate the condylar-shaft angle, and (iv) sagittal plane posterolateral scanning to evaluate the metaphyseal fracture gap.…”

Section: Discussionmentioning

confidence: 99%

“…Ultrasonography has advantages of being radiation-free and allowing clear visualization of the distal cartilage and dynamic monitoring of the reduction process. It effectively evaluates alignment after reduction and has been applied at different centers for various types of displaced HLCFs (13)(14)(15)(16)(17)(18). However, there has been no multicenter evaluation of the efficacy outcomes of UG-CRPP applied to unstable HLCFs, and the criteria for successful outcomes remain unclear.…”

mentioning

confidence: 99%

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Criteria of ultrasound-guided closed reduction with percutaneous pinning in unstable humeral lateral condylar fractures: a three-center retrospective cohort study

Huang,

Liu,

Jia

et al. 2024

Front. Pediatr.

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BackgroundInterventions using ultrasound-guided closed reduction and percutaneous pinning (UG-CRPP) of humeral lateral condylar fractures (HLCFs) have been increasingly applied; however, their effectiveness for unstable HLCFs and the criteria for ultrasound outcomes remain unclear. This study assessed the outcomes of UG-CRPP for HLCFs and evaluated the success criteria in children.MethodsData were retrospectively collected from 106 patients with unstable HLCFs admitted to three hospitals between January 2021 and August 2022. Fifty-five cases were left-sided and 51 cases were right-sided: 74 male patients and 32 female patients were included. Perioperative data, elbow function, complications, and criteria for UG-CRPP were analyzed.ResultsThe mean rate of UG-CRPP was 88%. The mean surgical time was 54.56 ± 21.07 min, and the mean fluoroscopy frequency was 9.25 ± 2.93 times. At the last follow-up, there were significant differences in elbow flexion between the affected side (135.82° ± 6.92°) and the unaffected side (140.58° ± 5.85°) (p = 0.01). The Mayo score of the affected side was 90.28° ± 4.97°, the Baumann angle was 71.4° ± 5.4°, condylar shaft angle was 39.9° ± 6.4°, and the carrying angle was 8.4° ± 3.6°. Seventy patients presented mild lateral spurs and 16 patients exhibited moderate spurs. Fourteen patients presented with pin infection, and one patient exhibited postoperative re-displacement. There was no premature physeal closure, varus, or valgus elbow deformity, delayed union, or non-union. Successful ultrasound-based outcome criteria for UG-CRPP were defined as follows: (i) absent or less than a cartilage thickness step on the cartilage hinge on coronal plane parallel articular surface scanning, (ii) no lateral displacement and intact distal end of the condylar and capitellum on coronal plane vertical articular surface scanning, (iii) no anteroposterior displacement and absent or less than a cartilage thickness step on sagittal plane vertical articular surface scanning, and (iv) intact posterior fracture line or less than a cortex step on posterolateral sagittal plane vertical articular surface scanning.ConclusionUG-CRPP is a procedure with minimal blood loss, less invasive, cosmetic, and no radiation exposure. It yielded good outcomes in unstable HLCFs. The successful criteria make it suitable for clinical application.

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Section: Discussioncontrasting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Criteria of ultrasound-guided closed reduction with percutaneous pinning in unstable humeral lateral condylar fractures: a three-center retrospective cohort study

Huang,

Liu,

Jia

et al. 2024

Front. Pediatr.

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“…In another study, 45 children with displaced supracondylar fractures of the humerus were studied, and the fractures were repositioned under ultrasound guidance while the ulnar nerve was detected by ultrasound, and no complications such as ulnar nerve injury or elbow inversion were found in any of the children 35 . In addition, several studies have demonstrated the promising use of ultrasound in pediatric fractures associated with nerve damage 39–42 …”

Section: Advantages Of Ultrasonography In Fracture Examinationmentioning

confidence: 99%

The emerging application of ultrasound technology in pediatric bone fractures: Clinical application, related issues and development prospect

Li,

Liu,

Shi

et al. 2024

Pediatric Discovery

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Ultrasonography has begun to be applied to the examination of fractures in recent years owing to its safety, noninvasiveness, portability, and high sensitivity. The subcutaneous soft tissue of children is thinner than that of adults, children's bones have a high level of elasticity and a low level of brittleness, and the pediatric fractures heal quickly and produce more callus, therefore ultrasonography is a more suitable examination in pediatric bone fractures. In this paper, we intend to review the mechanism, performance, and examination effect of ultrasound examination in bone fractures, analyze the advantages and disadvantages between ultrasound imaging and X‐ray imaging, and further propose an outlook for the application of ultrasound technology in pediatric bone fractures.

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“…US and MRI can identify a displaced ligament and/or entrapped supinator muscle in rare cases of failed reduction attempts. 42,43…”

Section: Imagingmentioning

confidence: 99%

Imaging Assessment of the Pediatric Elbow: Developmental Variants and Common Pathologies

Gendler,

Alizai,

Zoga

et al. 2024

Semin Musculoskelet Radiol

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The pediatric elbow is a complex joint that undergoes rapid growth and development. The normal anatomy of the elbow varies depending on the age of the patient, which can be challenging for imaging interpretation. This article reviews developmental variants and common pathologies of the pediatric elbow, with a focus on their radiologic features. Normal anatomy and development of the pediatric elbow are discussed, including the six ossification centers and elbow alignment. Congenital anomalies such as longitudinal deficiencies of the upper extremity are reviewed. Some common injuries that affect the elbow, such as supracondylar fracture, lateral condyle fracture, medial epicondyle avulsion, and radial head dislocation are also described.

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Ultrasonography of the pediatric elbow

Cited by 3 publications

References 43 publications

Criteria of ultrasound-guided closed reduction with percutaneous pinning in unstable humeral lateral condylar fractures: a three-center retrospective cohort study

Criteria of ultrasound-guided closed reduction with percutaneous pinning in unstable humeral lateral condylar fractures: a three-center retrospective cohort study

The emerging application of ultrasound technology in pediatric bone fractures: Clinical application, related issues and development prospect

Imaging Assessment of the Pediatric Elbow: Developmental Variants and Common Pathologies

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