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Elbow Fracture

Yoshihiko Satake, Yuji Tomori, Takuya Sawaizumi, Mitsuhiko Nanno, Norie Kodera, Shinro Takai
Medial epicondyle fractures of the humerus account for 11%-20% of all elbow injuries in children. Although intra-articular incarceration of the medial epicondyle occurs in 5%-18% of medial epicondyle fractures associated with an elbow dislocation, the mechanism of intrusion of the fracture fragment is unknown. We report a case of an irreducible elbow fracture and dislocation due to incarceration of the medial epicondyle fragment of the humerus, classified as a Watson-Jones type 3 fracture of the medial epicondyle, and present the mechanism of the intra-articular incarceration of the medial epicondyle fragment...
2018: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
Alysia K Robertson, Erica Snow, Theodora S Browne, Sha'Tia Brownell, Ifeoma Inneh, Jaclyn F Hill
PURPOSE: Although acute compartment syndrome (ACS) is associated with pediatric supracondylar humerus (SCH) fractures, there are limited data describing its incidence and risk factors. The purpose of our study was to report the local and national incidence of ACS with SCH and floating elbow (concomitant SCH and forearm) fracture patterns and the associated risk factors. METHODS: We retrospectively queried data for SCH fracture patients over a 4-year period from our institution (a level I pediatric trauma center) and the National Trauma Data Bank (NTDB)...
March 9, 2018: Journal of Pediatric Orthopedics
Shyam Kumar, Ulhas Sonar, Iqbal Singh
The incidence of fragility fractures of the humerus is increasing worldwide. Although clinicians are aware of fractures of hips and wrists, fractures of the shoulder and elbow do not receive much attention. A considerable proportion of the elderly population (estimated at 10-24%) is dependent on walking aids. A well-functioning and pain-free shoulder and elbow is essential for use of these aids. The impact of loss of mobility in the elderly is well known, hence the overall impact of these fractures on the individual can be considerable...
March 2, 2018: British Journal of Hospital Medicine
Valentin Rausch, Matthias Königshausen, Thomas A Schildhauer, Jan Gessmann, Dominik Seybold
Objective: Fractures of the capitellum are rare injuries but are often more complex and of a greater extent than assumed from conventional radiographs. Classification is usually based on their extension in relation to the trochlea the trochlea and on the number of fragments. Information on associated injuries is limited and only reported in small case series. The aim of this retrospective study was to report on our experience with capitellar fractures and their associated injuries. Methods: We retrospectively reviewed all patients treated for fractures of the capitellum humeri at our institute between 2005 and 2017...
2018: Obere Extremität
Rony-Orijit Dey Hazra, Helmut Lill, Gunnar Jensen, Julia Imrecke, Alexander Ellwein
Around one third of humeral fractures and 2-6% of all fractures occur to the distal part of the humerus. There is a bimodal distribution differentiating between young male patients with high-energy and elderly female patients with low-energy trauma related to osteoporosis. The AO classification and Dubberley subclassification are used in daily routine. Most fractures are diagnosed on radiographs. For further evaluation, three-dimensional computed tomography is recommended, especially for comminuted or complex fractures...
2018: Obere Extremität
Joel B Huleatt, Carl W Nissen, Matthew D Milewski
The treatment of sports injuries in the skeletally immature has a unique set of complications. Growth deformity may occur after anterior cruciate ligament reconstruction; therefore, skeletal age is used to help guide the choice between physeal sparing and transphyseal techniques. Arthrofibrosis after tibial spine fracture fixation can be reduced by initiating immediate range of motion, and should be treated early and cautiously to avoid iatrogenic fracture. Nonunions of medial epicondyle elbow fractures are more common with nonoperative treatment, but seldom lead to clinical problems outside of certain athletes...
April 2018: Clinics in Sports Medicine
D Bustamante-Suárez de Puga, R Cebrián-Gómez, E Villegas-Robles, J Sanz-Reig, J Más-Martínez, C M Verdú-Román, M Morales-Santías, E Martínez-Giménez
BACKGROUND: Open «arthrolysis» has been the standard treatment for elbow stiffness, with good results. However, the associated complications of open arthrolysis and the advancements in arthroscopic surgery have allowed including the latter as an additional approach. MATERIAL AND METHODS: Between January 2014 and March 2016, 6 patients with posttraumatic elbow stiffness underwent arthroscopic surgery by the same surgical team. Pre- and post-operative assessment included pain with a numerical visual analogue scale, elbow joint range of motion with a goniometer and the Mayo Elbow Performance Index questionnaire...
September 2017: Acta Ortopédica Mexicana
Mauricio Silva, Gal Sadlik, Tigran Avoian, Edward Ebramzadeh
BACKGROUND: The ideal type of immobilization for nondisplaced pediatric elbow fractures has not been established. We hypothesized that the use of a long-arm cylinder made of soft cast material will result in similar outcomes to those obtained with a traditional long-arm hard cast. METHODS: We randomly assigned 100 consecutive children who presented with a closed, nondisplaced, type I supracondylar humeral fracture or an occult, closed, acute elbow injury, to 1 of 2 groups: group A (n=50) received a long-arm, traditional fiberglass (hard) cast...
April 2018: Journal of Pediatric Orthopedics
Jason Silvestre, Joseph Upton, Benjamin Chang, David R Steinberg
BACKGROUND: Hand surgery fellowship programs in the United States are predominately sponsored by departments or divisions of orthopaedic surgery or plastic surgery. This study compares the operative experiences of hand surgery fellows graduating from orthopaedic or plastic surgery hand surgery fellowships. METHODS: Operative case logs of 3 cohorts of hand surgery fellows graduating during the academic years of 2012-2013, 2013-2014, and 2014-2015 were analyzed. The median case volumes were compared by specialty via Mann-Whitney U tests...
March 7, 2018: Journal of Bone and Joint Surgery. American Volume
Andrew Chia Chen Chou, Ho Yin Kevin Wong, Sumanth Kumar, Arjandas Mahadev
BACKGROUND: Distal humerus physeal separations are rare pediatric elbow fractures that are often misdiagnosed and difficult to treat. Adequate reduction is often technically challenging and up to 71% of children develop postoperative cubitus varus. We propose using the medial and lateral humeral lines as an adjunct to elbow arthrography in order to guide intraoperative fixation of distal humerus physeal separations to reduce the incidence of postoperative cubitus varus. METHODS: From 2009 to 2014, all pediatric patients under the age of 3 diagnosed with a distal humerus physeal separation and treated surgically at our institution were included for analysis...
March 5, 2018: Journal of Pediatric Orthopedics
David Drynan, Milford McArthur, Ashray Vohora, Darren Hinton, Grant Menegon, Matthew P R Wilkinson
BACKGROUND: Surgical planning in trauma is essential for optimal patient care and best patient outcomes. Digital radiography has improved the availability, convenience and access to radiographs worldwide as used in every trauma centre in Australia. One shortcoming, however, is the variability in magnification error associated with different anatomic regions. Accurate assessment of radiographs is paramount to proper surgical planning. METHODS: A retrospective review of 513 post-operative trauma radiographs of implants at a single centre, collected from January 2015 to August 2016, was measured by the four individual investigators...
March 1, 2018: ANZ Journal of Surgery
Ki-Tae Na, Seok-Whan Song, Yoon-Min Lee, Jae-Hoon Choi
BACKGROUND: Triceps weakness is a common complication of total elbow arthroplasty (TEA). Many posterior approaches for TEA have been introduced to maintain triceps function. The present study evaluated the clinical outcomes and extensor strengths of primary TEA with modified triceps fascial tongue approach. METHODS: Twenty-one primary TEAs performed in 20 patients by a single surgeon were reviewed with a mean of 64.2 months (range, 24-127 months) of follow-up. Every TEA was performed using the modified triceps fascial tongue approach, with the Coonrad-Morrey prosthesis...
February 26, 2018: Journal of Shoulder and Elbow Surgery
F F Fernandez, S Vatlach, T Wirth, O Eberhardt
The medial condyle fracture of the humerus is-in comparison to the lateral condyle fracture-a very rare Salter-Harrison IV-fracture of the elbow. In this prospective study 14 children were included and reviewed. One child had minimal displacement fracture type I, one child had type II, and 12 children had type III-fractures. One patient was treated conservatively by an upper arm cast; thirteen were surgically treated using open reduction and osteosynthetical treatment. Postoperatively the elbow was immobilized in 90° flexion and neutral position in a long-arm cast for 4-6 weeks...
February 26, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Joshua B Holt, Natalie A Glass, Apurva S Shah
BACKGROUND: Supracondylar humeral fractures (SCHF) are the most common elbow fractures in children. The epidemiology of these injuries in the United States is described. METHODS: The Nationwide Emergency Department Sample database was queried for all children (age, below 18 y) with SCHF treated in the emergency department (ED) from 2006 to 2011, and weighted estimates were extracted. RESULTS: A total of 63,348 ED visits for SCHF were identified...
February 16, 2018: Journal of Pediatric Orthopedics
Jeremy Kubik, Prism Schneider, Richard Buckley, Robert Korley, Paul Duffy, Ryan Martin
OBJECTIVES: The surgical reduction of intra-articular olecranon fractures is judged primarily on the lateral elbow radiograph, as orthogonal imaging of the articular surface is not obtainable. We sought to determine surgeon accuracy in identifying intra-articular olecranon malreductions on the lateral elbow radiograph. METHODS: Six human fresh-frozen cadaveric elbow specimens were sagittally sectioned in 5-mm increments after olecranon dissection, preservation of soft tissue envelope, and rigid fixation of the elbow in an external fixator...
March 2018: Journal of Orthopaedic Trauma
Sara L Dorman, James A Shelton, Robert Allen Stevenson, Kenneth Linkman, Jamie Kirkham, Daniel C Perry
BACKGROUND: Medial humeral epicondyle fractures of the elbow are one of the most common injuries in childhood and often require surgery. There are currently no standardised outcome measures to assess progress after an elbow injury in a child. Wide variation in currently reported outcomes makes comparison of treatment difficult. This study aims to identify outcome measures that have previously been reported in studies evaluating the management of medial epicondyle fractures in children and to facilitate the development of a consensus core outcome set (COS) suitable for use in all future studies of medial humeral epicondyle fractures in children...
February 20, 2018: Trials
Zhen Xu, Mei-Jin Hu
OBJECTIVE: To investigate effects of elastic stable intramedullary nails(ESIN) for the treatment of radial neck fracture in children. METHODS: From January 2014 to April 2017, 18 children with radial neck fractures were treated with minimally invasive internal fixation including 6 males and 12 females with an average age of 8.6 years old ranging from 4 to 15 years old; 7 cases were on the left, 11 cases on the right. According to Judet type, 5 cases were type II, 9 cases were type III, 1 case was type IVa, 3 cases were type IVb...
October 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Yun-Xiang Zhong, Xiong-Hui Zhang, Guo-Xiong Cai, Hong-Zhi Zhou, Wen-Li Yang, Xi-Bin Pan, Long-Zhou Guan, Huo-Ling Zhang
OBJECTIVE: To investigate the efficacy, advantages and disadvantages of internal and external elbow joint approach and olecranon osteotomy approach for the treatment of intercondylar fracture of humerus. METHODS: From October 2012 to May 2016, 18 cases of intercondylar fracture of humerus were treated by operation including 12 males and 6 females with a mean age of 33.5 years old (ranged from 4 to 56 years old); 8 cases were operated by internal and external elbow joint approach, 10 cases were operated by olecranon osteotomy approach...
October 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Zhi Tang, Shao-Dong Xie, Shen Cao, Qian Cao, Yun-Qin Yang
No abstract text is available yet for this article.
November 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Guan-Yi Liu, Ling-Yong Jing, Zhi-Jun Pan, Long-Jun Chen, Ming Li, Jian-Xiang Feng, Wei-Hu Ma
OBJECTIVE: To explore the clinical outcomes of internal fixation or replacement for the treatment of radial head fractures through the extensor digitorum communis splitting approach. METHODS: From July 2012 to May 2015, 25 patients with radial head fractures were reviewed. There were 17 males and 8 females, ranging in age from 20 to 67 years old, with a mean age of 39 years old. Twenty-one patients were treated with reconstruction of plate internal fixation, and 4 patients were treated with radial head replacement...
November 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
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