Treatment of Displaced Supracondylar Fracture of Humerus in Children with Percutaneous Pinning in Misurata Central Hospital
الكلمات المفتاحية:
Percutaneous pinning، Supracondylar fracture، Humerus، Childrenالملخص
Background: Supracondylar fracture of humerus is the most common fracture in the first decade of life. There are various treatment modalities for this fracture; closed reduction and casting adhesive skin traction as described by Dunlop, overhead skeletal traction from the olecranon, closed reduction and percutaneous pin fixation, and lastly open reduction and internal fixation.
Aim: To evaluate the outcome of closed percutaneous pinning of displaced Supracondylar fracture of humerus in children.
Material and Methods: A retrospective study conducted at Orthopaedic surgery department of Misurata central hospital. The Records of 43 children with displaced supracondylar fractures of the humerus (Gartland type II & III ) admitted from April 2004 through April 2006 were reviewed. Outcome measures were based on Flynn criteria, namely loss of elbow motion & carrying angle.
Results: The mean age of the 43 patients was 7 years (ranging between 2-12 years).The mean follow- up period was 9 months (ranging between 3 - 18 months). 7o % of the fractures occurred in boys and 30% in girls. The involved side was right elbow in 32 cases (75%) and left in 11 cases (25%. 40 cases (95%) had extension type & 3 cases (5%) had flexion type of fracture. Gartland type II cases were 13 (30%) & type III cases were 30(70%). Our results showed excellent outcome in 28 patients (65)%,good outcome in 9 patients (21%) and poor outcome in 6 patients (14%).
Conclusion: percutaneous pinning of supracondylar fracture of humerus in children is safe, cost- effective, and time-saving and provides greater skeletal stability with excellent results.
المراجع
William R., Sutton, Walter R. Greene, GAIA, Geurgopoulos and Thomas B., Displaced supracondylar humeral fractures in children, Clin. Orthop.,278: 81, 1992.
Sharrard WJW., Pediatric orthopedics and fractures, 3ed ed., Oxford, Edinburg: Black well Scientific Publications 3: 1391-408, 1993.
Siris IE. Supracondylar fractures of the humerus. An analysis of 330 cases. Surg Gynecol Obstet 68 :201, 1939 .
Haddad RJ Jr, Saer JK, Riordan DC. Percutaneous pinning of displaced supracondylar fractures of the elbow in children. Clin Orthop. 71 : 112 – 117,1970 .
Flynn JC, Matthews JG m, Benoit RI. Blind pinning of displaced supracondylar fractures of the humerus in children. Sixteen years' experience with long-term follow-up. J Bone joint Surg. 56- A:263-272,1974.
Mehserle WL., Meehan PL. Treatment of the displaced supracondylar fracture of the humerus (type III) with closed reduction and percutaneous cross-pin fixation. J Pediatr. Orthop. 11 :705- 711, 1991.
Swenson AL., Treatment of supracondylar fractures of the humerus by Kirschner wire transfixation. J. Bone and Joint Surg. 30-A:993-7, 1948.
Sandegard E., Fractures of lower end of humerus in children. Treatment and results. Act Chir. Scand, 89 :116-9, 1944.
wikins k. E., Supracondylar fractures of the humerus in children. Rockwood and Green. Fractures in children, 3rd ed. New York. London, Hagerstown: JB Lippincott company, 3: 509-617,1991.
Flynn J.C., Mattews J. G., Beriot R.L., Pinning of displaced supracondylar fracture of humerus in children. J. Bone and Joint Surg.. 56-A: 263-72, 1974 .
GÜrkan Öz., Ugur G., Asim k., Displaced supracondylar humeral fractures in children. Open reduction vs. closed reduction and pinning. J. Orthop. Trauma 8:547-551, 2004.
O`hara L.J., Barlow, J. W., Clarke, N.M.P. , Displaced Supracondylar Fracture of humerus in children., J Bone and Joint Surg. 82-B:204-10, 2000.
Gartland JJ. Management of supracondylar fracture of humerus in children. Surg. Gynecol Obstet 109:145-54, 1959 .
Mostafani HR., Spero C., Crossed pin fixation of displaced supracondylar humerus fractures in children. Clin Ortho. 376:56-61 2000.
Hisham H. Refaie., Treatment of supracondylar fracture of humerus in children with percutaneous pinning. The Egyptian Orthopaedic Journal 25:37-46 1990.
Piron AM. , Gromam HK., Kraj Bich JI. Management of displaced extension type of supracondylar fracture of humerus in children. J Bone and Joint Surg. 70-A:641-50, 1988.
Ababmch M. Shmmak A. Agabi S., Hadad S. The treatment of displaced supracondylar fracture of the humerus in children. A comparison of three methods . Int Orthop. 22:263-5.
Cekanauska E., Degliute R., Kalesimskas RJ. Treatment of supracondylar fracture in children according to Gartland classification. Medicina (kaunas) 39:379-83 2003.
