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Supracondylar humeral fracture

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https://www.readbyqxmd.com/read/29762292/a-dedicated-satellite-trauma-orthopaedic-program-operating-room-safely-increases-capacity
#1
Peter M Waters, Brian W Yang, Doreen White, Ellen Barth, Vincent Chiang, Arielle Mizrahi-Arnaud, William Sparks
BACKGROUND: Providing high-value care for urgent orthopaedic trauma patients requires effective and timely treatment. Herein, we describe the implementation of an innovative program utilizing the operating room (OR) capacity of a satellite campus to decrease stress on a pediatric tertiary care center without jeopardizing patient safety. METHODS: In addition to the daily emergency surgical room on the main campus, a dedicated orthopaedic trauma surgery OR was established in a satellite hospital location for 3 days per week in the summer and for 2 days per week for the rest of the year...
May 16, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29755914/supracondylar-humeral-fractures-an-audit-of-the-frequency-of-bi-columnar-fixation-and-intra-articular-wire-placement
#2
Andrew Ker, Claire Murnaghan, James S Huntley
Introduction For supracondylar humeral (SCH) fractures, biomechanical studies suggest the most stable wire configuration achieves bi-columnar fixation. Achieving medial column fixation using lateral-entry-only wires may require an intracapsular entry point. The aim of this study was to identify the rate of bi-columnar fixation achieved in our department when treating SCH fractures with percutaneous wire fixation. A secondary aim was to identify the rate of placement of an intra-articular wire. Further aims were to examine if failure to achieve bi-columnar fixation was associated with an increased loss of fixation and whether the placement of an intra-articular wire resulted in any cases of deep infection or septic arthritis...
March 13, 2018: Curēus
https://www.readbyqxmd.com/read/29719747/the-influence-of-resident-level-of-training-on-fluoroscopy-time-in-pediatric-supracondylar-humeral-fractures-treated-with-closed-reduction-and-percutaneous-pinning
#3
Önder Kalenderer, Ali Turgut, Emre Bilgin, Serkan Erkus, Fikri B İpci, Tunc P Edizsoy
Objective The purpose of this study was to evaluate the effect of resident level of training on fluoroscopy duration in pediatric supracondylar humeral fractures treated with closed reduction and percutaneous pinning (CRPP). Methods After classifying the surgeons according to their seniorities, the duration of fluoroscopy time of 80 patients with extension type III supracondylar fractures during reduction and pinning was recorded. Results The time duration of reduction procedures was similar in all groups with respect to the surgical experience; however, time durations of percutaneous pinning procedures were found statistically different between groups (p=0...
February 28, 2018: Curēus
https://www.readbyqxmd.com/read/29708571/reliability-of-the-anterior-humeral-line-index-compared-with-the-gartland-classification-for-posteriorly-hinged-supracondylar-humerus-fractures
#4
Margaret Siobhan Murphy-Zane, Laura Pyle
The Gartland classification of pediatric supracondylar humerus (SCH) fractures is commonly used but inconsistently defined regarding type 1 and type 2 (posteriorly hinged) SCH fractures. This study examined the reliability of the anterior humeral line (AHL) index compared with the Gartland classification. Fifty consecutive SCH fractures on anteroposterior and lateral elbow radiographs in pediatric patients (age range, 18 months to 15 years) were classified by 11 observers (9 attendings and 2 residents) according to the Gartland classification (types 1, 2, and 3) and the AHL index (AHL0, AHL passes anterior to the capitellum; AHL1, anterior one-third capitellum; and AHL2, middle one-third capitellum), with recommendations for treatment (cast immobilization vs surgery)...
April 27, 2018: Orthopedics
https://www.readbyqxmd.com/read/29664879/surgical-treatment-of-supracondylar-humeral-fractures-in-a-freestanding-ambulatory-surgery-center-is-as-safe-as-and-faster-and-more-cost-effective-than-in-a-children-s-hospital
#5
Carson M Rider, Victor Y Hong, Timothy J Westbrooks, Jiajing Wang, Benjamin W Sheffer, Derek M Kelly, David D Spence, John M Flynn, Jeffrey R Sawyer
BACKGROUND: Despite an 88% increase in the number of pediatric fractures treated in ambulatory surgery centers (ASCs) over a 10-year period, few studies have compared outcomes of fracture treatment performed in a freestanding ASC compared with those performed in the hospital (HOSP) or hospital outpatient department (HOPD). The purpose of this study was to compare clinical and radiographic outcomes, treatment times, and costs for treatment of Gartland type II supracondylar humeral (SCH) fracture in the ASC, HOSP, and HOPD...
April 16, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29628711/does-the-surgery-time-affect-the-final-outcome-of-type-iii-supracondylar-humeral-fractures
#6
Magdalena Kwiatkowska, Baljinder Singh Dhinsa, Anant Narayan Mahapatra
Introduction: Supracondylar humeral fractures are common in the pediatric population, with displaced fractures requiring operative intervention. The purpose of this study was to look at our practice and assess whether a difference in clinical outcomes and requirement for open reduction was observed if surgery was delayed. Methods: This was a retrospective medical record and plain radiograph review of patients admitted with type III Gartland supracondylar fractures between January 2014 and December 2015...
March 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29615086/comparison-of-lateral-entry-with-crossed-entry-pinning-for-pediatric-supracondylar-humeral-fractures-a-meta-analysis
#7
Yuyan Na, Rui Bai, Zhenqun Zhao, Changxu Han, Lingyue Kong, Yizhong Ren, Wanlin Liu
BACKGROUND: The standard treatment for severe displaced pediatric supracondylar humeral fracture (SCHF) is closed reduction and percutaneous pin fixation. However, controversy persists concerning the optimal pin fixation technique. The purpose of this study was to compare the safety and efficacy on the configuration of lateral entry only with crossed entry pin fixation for SCHF, including Gartland type II and type III fractures in children. METHODS: Published literatures, including retrospective studies, prospective studies, and randomized controlled trials, presenting the probability of poor functional consequence of elbow and/or loss of reduction and/or iatrogenic ulnar nerve injury and/or superficial infection and/or cubitus varus were included...
April 3, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29517983/a-removable-long-arm-soft-cast-to-treat-nondisplaced-pediatric-elbow-fractures-a-randomized-controlled-trial
#8
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
https://www.readbyqxmd.com/read/29464293/-kirschner-wire-osteosynthesis-for-fractures-in-childhood-bury-wires-or-not-results-of-a-survey-on-care-reality-in-germany
#9
D Schneidmueller, M Kertai, V Bühren, C von Rüden
INTRODUCTION: Kirschner wire osteosynthesis is considered to be the standard technique for surgical fixation of displaced supracondylar humeral and distal radial fractures in children. The Kirschner wires can be left exposed or buried under the skin. Advantages of the epicutaneous technique are, e. g. the efficiency (cost, effort) and the possibility for wire removal without the necessity of a second anesthesia. On the other hand, there is a concern about higher infection rates as well as traumatization of the children due to externally visible wires...
February 20, 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/29462120/understanding-the-epidemiology-of-pediatric-supracondylar-humeral-fractures-in-the-united-states-identifying-opportunities-for-intervention
#10
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...
May 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29451050/9-years-follow-up-of-168-pin-fixed-supracondylar-humerus-fractures-in-children
#11
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)...
June 2018: Acta Orthopaedica
https://www.readbyqxmd.com/read/29273387/experience-and-volume-are-determinantive-factors-for-operative-management-of-supracondylar-humeral-fractures-in-children
#12
Sébastien Pesenti, Alexandre Ecalle, Emilie Peltier, Elie Choufani, Benjamin Blondel, Jean-Luc Jouve, Franck Launay
BACKGROUND: We compared radiographic and operative results of pediatric patients undergoing surgical treatment of displaced supracondylar humeral fracture (SCHF) according to the surgeon's experience. METHODS: During an 11-year period (2006-2016), we reviewed the medical records of 236 patients operated on for Gartland III SCHF in our institution. Operative (operative time, time to implants removal) and radiographic parameters (Baumann and lateral capitellohumeral angles) were assessed...
March 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29206799/simulation-based-educational-module-improves-intern-and-medical-student-performance-of-closed-reduction-and-percutaneous-pinning-of-pediatric-supracondylar-humeral-fractures
#13
Bennet A Butler, Cort D Lawton, Jamie Burgess, Earvin S Balderama, Katherine A Barsness, John F Sarwark
BACKGROUND: Simulation-based education has been integrated into many orthopaedic residency programs to augment traditional teaching models. Here we describe the development and implementation of a combined didactic and simulation-based course for teaching medical students and interns how to properly perform a closed reduction and percutaneous pinning of a pediatric supracondylar humeral fracture. METHODS: Subjects included in the study were either orthopaedic surgery interns or subinterns at our institution...
December 6, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29192344/pulseless-supracondylar-humeral-fractures-in-children-vascular-complications-in-a-ten-year-series
#14
Adeline Cambon-Binder, Pascal Jehanno, Laurent Tribout, Philippe Valenti, Anne-Laure Simon, Brice Ilharreborde, Keyvan Mazda
PURPOSE: The management of pulseless supracondylar fractures remains controversial. The aims of this study were to: (1) analyse functional and vascular outcomes of conservative treatment for cases with absent pulse before reduction, whether patients showed limb ischaemia or not; and (2) identify factors associated with vascular complications. METHODS: Twenty-seven children with absent pulses on presentation were treated consecutively between 1999 and 2009. The brachial artery was surgically explored in cases of persistent signs of ischaemia after reduction...
November 30, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/29189532/pediatric-supracondylar-humerus-fractures-aaos-appropriate-use-criteria-versus-actual-management-at-a-pediatric-level-1-trauma-center
#15
Joanne H Wang, William Z Morris, Blaine T Bafus, Raymond W Liu
OBJECTIVES: The purpose of this study was to characterize management of supracondylar humerus fractures (SCHFs) at a level 1 trauma center and identify factors contributing to divergence in management from American Academy of Orthopedic Surgeons (AAOS) the Appropriate Use Criteria (AUC) recommendations. METHODS: A query revealed 556 patients with diagnoses of SCHF between 2013 and 2015 at a pediatric level 1 trauma center. Patients were excluded if they were younger than 2 years of age, older than 12 years of age, were polytrauma patients, or if there was not sufficient clinical or radiographic documentation, resulting in 449 patients...
November 16, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29185384/treatment-of-displaced-flexion-type-pediatric-supracondylar-humeral-fractures-in-the-prone-position
#16
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
https://www.readbyqxmd.com/read/29182131/lateral-pinning-versus-others-procedures-in-the-treatment-of-supracondylar-humerus-fractures-in-children
#17
COMPARATIVE STUDY
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
https://www.readbyqxmd.com/read/29094012/managing-extremely-distal-periprosthetic-femoral-supracondylar-fractures-of-total-knee-replacements-a-new-philos-ophy
#18
Kevin J Donnelly, Adam Tucker, Angel Ruiz, Neville W Thompson
We report two cases where a proximal humeral locking plate was used for the fixation of an extremely distal, type III peri-prosthetic femoral fractures in relation to a total knee replacement (TKR). In each case there was concern regarding the fixation that could be achieved using the available anatomic distal femoral plates due to the size and bone quality of distal fragment. The design of the Proximal Humeral Internal Locking System (PHILOS) allows nine 3.5-mm locking screws to be placed over a small area in multiple directions...
October 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/29053499/the-community-orthopaedic-surgeon-taking-trauma-call-pediatric-supracondylar-humeral-fracture-pearls-and-pitfalls
#19
Steven L Frick, Charles T Mehlman
Supracondylar humeral fractures are the most common type of pediatric elbow fracture. With proper treatment, these injuries usually heal well and the patients return to full function. However, a small percentage of these injuries may result in devastating complications and, thus, provoke anxiety in many surgeons treating them. This article provides tips for successful management of these injuries without complications and provides references for further study.
November 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29022039/paediatric-supracondylar-humeral-fractures-a-technique-for-safe-medial-pin-passage-with-zero-incidence-of-iatrogenic-ulnar-nerve-injury
#20
Chin Yee Woo, Han Loong Ho, Mohammad Bin Zainuddin Ashik, Kevin Boon Leong Lim
INTRODUCTION: The cross Kirschner wire (k-wire) configuration in closed reduction and percutaneous pinning of paediatric supracondylar humeral fracture afford superior stability. However, medial pin placement presents a risk of iatrogenic ulnar nerve injury. This study describes, in step-by-step detail, another safe method of percutaneous medial pin insertion. METHODS: The technique involved placing the patient's arm in external rotation, with elbow flexed no more than 45° after closed reduction...
October 12, 2017: Singapore Medical Journal
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