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Children 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
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
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
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
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
Noora Tuomilehto, Antti Sommarhem, Aarno Y Nietosvaara
Background and purpose - The long-term outcome of pin-fixed supracondylar humerus fractures (SCHF) in children is not well known. We assessed the 7- to 12-year outcome in 168 children. Patients and methods - During 2002-2006, 210 domestic children (age 7 (1-14) years) with SCHF (Gartland III 79%, Gartland II 19%, and flexion type 2%) were pin fixed in Helsinki. 36 (17%) patients had a nerve palsy. Radiographic alignment was regarded as satisfactory in 81% of patients (Baumann angle (BA) within ±10˚ of normal range and whose anterior humeral line (AHL) crossed the capitulum)...
February 16, 2018: Acta Orthopaedica
Chao-Feng Zhao, Quan-Yang Gao, Tian-Jian Zhang, Lu-Li Han, Jun-Feng Zhao, Gang Chen, Yu Cui
OBJECTIVE: To explore the clinical effect of closed reduction and minimally invasive treatment of humeral shaft fractures in children. METHODS: From July 2011 to April 2015, 39 cases of pediatric humeral shaft fractures were treated by closed reduction and external fixation, including 27 males and 12 females with a mean age of 8.6 years old ranging from 3 to 14 years old. Time from injury to the treatment was 2 h to 7 days with an average of 2.7 days. There were 6 cases of upper fracture, 21 cases of middle fracture and 12 cases of lower fracture...
July 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Mahmut Kalem, Ercan Şahin, Hakan Kocaoğlu, Kerem Başarır, Hakan Kınık
INTRODUCTION: This paper aims to compare the clinical and radiological results of children operated using elastic stable intramedullary nailing as described by Métaizeau to those with the closed reduction and percutaneous pinning (CRPP). METHODS: Results of 21 pediatric patients with radial neck fracture who were treated by two pediatric surgeons between January 2011 and December 2013 were reviewed retrospectively. 10 were treated with the Métaizeau method versus 11 with the CRPP...
January 25, 2018: Injury
Xia Lan, Min Dai, Bin Zhang, Gendong Huang
PURPOSE: The purpose of this study was to compare the surgical findings and clinical outcomes of the lateral condylar fractures of the humerus with or without posteromedial elbow dislocation in children. METHODS: Between January 2013 and June 2016, a total of 21 Milch type II humeral condylar fractures were treated with open reduction and internal fixation. The average follow-up was 2.8 years (range, 1 to 4 years). There were 8 patients in group A with posteromedial elbow dislocation and 13 patients in group B without dislocation...
February 1, 2018: International Orthopaedics
Kai Liu, Ru-Guo Shang, Yan Xiao, Jan-Wei Hu, Yong-Xin Yu
OBJECTIVE: To study clinical effects of operation for the treatment of old fractures of the humerus lateral condyle in children. METHODS: From January 2012 to January 2014 in our department, 14 children of old humeral lateral condyle fractures were treated with operation. Ten cases were male, 4 cases were female; age from 2 to 12 years old, average 5.8 years old. The initial diagnosis was type IIfracture according to the Milch ciassification, the loss of treatment in 11 cases, conservative treatment in 3 cases of nonunion after fracture displacement...
January 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Xin Li, Hong Liu, Sheng Xiao, Ke Fang, Jie Wen
OBJECTIVE: To investigate the clinical outcomes of limited open reduction and percutaneous K-wire internal fixation for the treatment of irreducible Gartland type III humerus supracondylar fracture in children. METHODS: From May 2006 to October 2014, 132 patients with irreducible Gartland type III humerus supracondylar fracture were treated with reduction and percutaneous K-wire internal fixation. The reduction was performed with the guiding of surgeon's finger, and the lateral approach with periosteum torn was chosen according to the shift direction of the distal fractures...
January 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Xuemin Lu, Guisen Yan, Ming Lu, Yuan Guo
This study was conducted to explore epidemiologic features of traumatic elbow dislocation with associated fractures in pediatric population following appropriate treatment options.Incidence of elbow dislocation with associated fractures was analyzed in 67 children using elbow radiographs. Treatment for the displaced elbow joint was performed by closed reduction and proper immobilization. Surgical intervention was applied to restore the correct alignment of the fracture. Mayo Elbow Performance Score (MEPS) was used to measure elbow joint function...
December 2017: Medicine (Baltimore)
Mehmet Demirel, Onur Tunali, Ismail Turkmen, Yavuz Saglam
Introduction: Although supracondylar fractures of the humerus are common in children, open fractures of are extremely rare injuries. Gustilo- Anderson Type-III fractures in the upper extremity are primarily associated with considerable bone loss resulting from high energy trauma. In this study, a case of open pediatric supracondylar humerus fracture treated by a joint and defect spanning multiplanar tubular external fixation is presented. Case Report: A boy aged 3 years suffered from a Gustilo-Anderson Type-IIIA supracondylar humerus fractures...
September 2017: Journal of Orthopaedic Case Reports
Yasser Abed, Khaled Nour, Yasser Roshdy Kandil, Abed El-Negery
BACKGROUND: Long standing nonunion of the lateral humeral condyle (LHC) usually results in elbow pain and instability with progressive cubitus valgus and tardy ulnar neuritis. Surgical treatment of long standing nonunion is still a controversial issue due to the reported complications, such as stiffness, loss of elbow motion, and avascular necrosis of the LHC fragment. In this study, we reported the outcomes of treatment of cubitus valgus deformity in long standing nonunion of the LHC in children treated with combined triple management (fixation of the nonunion site, dome corrective osteotomy, and anterior transposition of ulnar nerve) through a modified para-triceptal approach...
February 2018: International Orthopaedics
Tamer Ahmed El-Sobky, John Fathy Haleem, Hossam Moussa Sakr, Ahmad Saeed Aly
Humeral medial epicondyle fractures constitute around 15% of pediatric elbow fractures. Up to 60% occur in association with elbow dislocations. Knowledge of potential imaging pitfalls when examining acute elbow fractures in children contributes significantly to accurate diagnosis. Nevertheless, management of missed pediatric medial epicondyle fractures has rarely been reported. We present an 11-year-old boy with a neglected and severely displaced medial epicondyle fracture with concurrent ulnar nerve palsy...
December 2017: Clinics in Orthopedic Surgery
Hsuan-Kai Kao, Wei-Chun Lee, Wen-E Yang, Chia-Hsieh Chang
PURPOSE: This study is to report a new method to reduce and fix the displaced flexion-type pediatric supracondylar fracture in the prone position. METHODS: Ten children with displaced flexion-type supracondylar humeral fractures treated between 2007 and 2013 were reviewed. There were three girls and seven boys, with a mean age of 9.5 years. The fracture was reduced by gentle traction of the forearm and gradual extension of the elbow in the prone position. Two or three crossed Kirschner wires (K-wires) were inserted percutaneously to secure the fracture reduction...
January 1, 2017: Journal of Orthopaedic Surgery
G Frongia, C Janosi, A Mehrabi, J-P Schenk, P Günther
BACKGROUND: The aim of this study was to investigate the long-term clinical outcome following open reduction and internal screw fixation of displaced lateral condyle fractures (LCFs) of the distal humerus and compare the outcome of primary and secondary LCFs. METHODS: The clinical outcome in 31 children (mean age 5.8±2.4 years) operated for primary or secondary LCFs was retrospectively analyzed by standardized clinical examination and compared using the Mayo score, Morger score, and Patients Satisfaction score...
December 2016: Acta Orthopaedica Belgica
N Begovic, Z Paunovic, Z Djuraskovic, L Lazovic, T Mijovic, S Babic
We compared results of lateral pinning procedure with crossed pinning, closed reduction, and open reduction in a retrospective review of 184 patients with displaced supracondylar humeral fractures. All patients had a minimum of 2 years follow-up (range 36-90 months). Patients were separated into 4 groups. Success was estimated by Flynn's criteria. We compared success of the lateral pinning to others procedures. Incidence of nerve palsy was recorded and compared. Esthetic effect of lateral pinning is significantly better than closed reduction (p=0...
December 2016: Acta Orthopaedica Belgica
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