Radiographic Assessment in the Treatment of Supracondylar Humerus Fractures in Children - Zdravlje, medicina, lijecenje, zdravstveni portal

Radiographic Assessment in the Treatment of Supracondylar Humerus Fractures in Children

Radiographic Assessment in the Treatment of Supracondylar Humerus Fractures in Children

Ivanka Madjar-Simic, Adnana Talic-Tanovic, Zoran Hadziahmetovic, Aida Sarac-Hadzihalilovic

Acta Inform Med. 2012; 20(3): 154-159

View PDF Fulltext

ABSTRACT

Introduction: Supracondylar humerus fractures are the most common fractures of the humerus at the elbow in children. The key role belongs to the age and immaturity of the humerus region. Treatment, even today represents the problem of bone and joint surgery. Gartland classification divides these fractures into four types. Analysis of radiographic parameters will serve as an indicator for treatment selection. Goal: To demonstrate the role of radiographic evaluation by measurement of default radiographic parameters and indicate the choice of treatment for supracondylar fractures of type I and II by Gartland. Material and methods: The study included 60 children aged 4-14 years, divided into two groups, first with initial radiographic analysis and the second one without radiographic analysis. All were treated at the Primary Health Care Center Novi Travnik and Nova Bila Hospital from 2009 to 2011. Analysis was performed using methods of descriptive statistics to calculate the mean and standard deviation, Student’s t-test and Chi-square test. Results: In patients from first group hospitalization, immobilization duration, as well as physical treatment was shorter and more frequently surgical treatment was applied (manual reduction with K-wire fixation) with statistically significant difference (p = 0.042). Conclusion: Radiographic evaluation is one way to choose methods of fracture treatment. The incidence of complications is low, with excellent outcome of treatment and a faster return of children to their daily activities.

REFERENCES

1. Gartland JJ. Management of supracondylar fractures of the humerus in children. Surg Gynecol Obstet. 1959; 109: 145-154.

2. O’Hara LJ, Barlow IW, Clarke NMP. Displaced supracondylar fractures of the humerus in children. J Bone Joint Surg [Br]. 2000; 82-B: 204-210.

3. Wilkins KE. Fractures and dislocations of the elbow region. In: Rockwood CA, Wilkins KE, King RE, eds. Fractures in children. Vol. 4th edition. Philadelphia: Lippincott–Raven Publishers, 1996: 680.

4. Agur MRA, Dalley FA. Grantov anatomski atlas. Ed. 12. Romanov, Banjaluka, 2005: 475-549 (ed. in Serbian).

5. Davis RT, Gorczyca JT, Pugh K, Supracondylar humerus fractures in children. Comparison of operative treatment methods. Clin Orthop Relat Res. 2000; 49-55.

6. Ruedi T, Murphy WM, AO Principles of Fracture Management. Vol. 1. Thieme: Stuttgart, New York. 2000.

7. Vuckov Š, Kvesic A. Koštana trauma lokomotornog aparata, U: Vuckov Š, Kvesic A. Izabrana poglavlja iz djecje kirurgije. Mostar: VMG Grafika, 2005; 289-420.

8. Nacht JL, Eker ML, Chug SMK et al, Supracondylar fracture of the humerus in children treated by closed reduction and percutaneous pinning. Clin Orthop Relat Res. 1983; 177: 203.

9. Campbell C, Waters P, Emans J et al, Neurovascular injury and displacement in type III supracondylar humerus fractures. J Pediatr Orthop. 1995; 25: 47.

10. Skaggs DL, Hale JM, Bassett J et al. Operative treatment of supracondylar fractures of the humerus in children. The consequences of pin placement. J Bone Joint Surg Am. 2001; 83A: 735-740.

11. Arino VC, Lluch EE, Ramirez AM et al, Percutaneous fixation of supracondylar fractures of the humerus in children. J Bone Joint Surg Am. 1997; 59: 914.

12. Buturovic S. Komparacija rezultata lijecenja prijeloma distalnog humerusa kod djece prema indikaciji za konzervativno ili operativno rješenje, Doktorska disertacija, Univerzitet u Sarajevu, 2006.

13. Skaggs DL. Mirzayan R. The posterior fat pad sign in association with occult fracture of the elbow in chidren. J Bone Joint Surg (Am). 1999; 81A: 1429-1433.

14. Kim HT. Song MB. Conjares NV. Yoo ChI. Trochlear deformity occurring after distal humeral fractures: Magnetic resonance imaging and its natural progression. J Pediatr Orthop. 2002; 22: 188-193.

15. Green DW. Widmann RF. Frank JS. Gardner MJ. Low incidence of ulnar nerve injury with crossed pin placement for pediatric supracondylar humerus fractures using a min technique. J Orthop Trauma. 2005; 19: 158-163.

16. Farley F, Patel P, Craing CB, Lakemore L, Hensinger R, Zhang L, Caird M, Pediatric supracondylar humerus fractures: treatment by type of orthopedic surgeon. J Child Orthop. 2008; 2.

17. Flynn JC, Matthewas JG, Beniot RL. Blind pinning of displaced supracondylar fractures of the humerus in children: sixteen years experience with long-term follow-up. J Bone Joint Surg (Am). 1974; 56: 263-272.

18. Mortensson W, Thonell S, Left-side dominance of upper extremity fracture in children. Acta Orthop Scand. 1991; 62(2): 154-155.

19. Williamson DM, Coates CJ, Miller RK, Cole WG. The normal characteristics of the Baumann (humero-capitellar) angle: an aid in the assessment of supracondylar fractures. J Pediatr Orthop. 1992; 12: 636-639.

20. Gajdobranski Đ, Maric D, Tatic M, Đuric-Nosek D, Mikov A. Osteosinteza Kiršnerovim iglama u lecenju dislociranih suprakondilarnih preloma humerusa kod dece. Med. pregl. 2003; LVI (7-8): 355-361.

21. Royce RO, Dutkowsky JP, Kasser JP. et al. Neurological complication after K-wire fixation of supracondylar fractures of the humerus in children. J Pediatr Orthop. 1992; 11: 191-194.

22. Otsuka NY, Kasser JR. Supracondylar fractures of the humerus in children. J Am Acad Orthop Surg. 1997; 5(1): 19-26.

23. Topping RE, Blanco JS, Davis T. Clinical evaluation of crossed pin versus lateral pin fixation in displaced supracondylar fractures of the humerus. J Pediatr Orthop. 1995; 15: 435-439.

24. Lee B, Lee S, Kim S, Park W, Kim T, Park K. Radiographic Outcomes After Treatment of Pediatric Supracondylar Humerus Fractures Using a Treatment-Based Classification System. J. Orthop Trauma. 2011; 25(19: 18-25.

25. Tiwari A, Kanojia RK, Kapoor SK. Surgical management for late presentation of supracondylar humeral fracture in children. J Orthop Surg (Hong Kong). 2007; 15(2): 177-182.

26. Kasser JR. Location of treatment of supracondylar fractures of the humerus in children. Clin Orthop Relat Research. 2005; 434: 110-113.

27. Oztürkmen Y, Karamehmetoglu M, Azboy I. Closed reduction and percutaneous pin fixation in the treatment of displaced supracondylar fracture of the humerus in children. Acta Orthop Traumatol Turc. 2005; 39(5): 396-403.

28. Özkoc G. Gonc U. Kayaalp A. Teker K. Peker TT. Displaced supracondylar humeral fractures in children: open reduction vs. closed reduction and pinning. Arch Orthop Trauma Surg. 2004; 124: 547-551.

Leave a reply

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <s> <strike> <strong>