Severely displaced humeral supracondylar fracture gartland iii carries the risks. The fact sheet details the care in the first few days, what is normal and what is an emergency requiring urgent medical treatment. Treatment of completely displaced supracondylar fracture of the. Kwire fixation of supracondylar humeral fractures in. Would you recommend surgery for a supracondylar fracture of the distal humerus on a 79 year old female with adequatelycontrolled niddm. The epub format uses ebook readers, which have several ease of reading features already built in. Get the best in trauma literature at 2000 inr per year. Treatment of pediatric supracondylar humerus fractures case study. Supracondylar fractures are the most common upper extremity fracture in the pediatric population therfore every emergency medicine provider should be deeply familiar with the known complications of such pathology. Easy and secure online payment and book delivered at your doorsteps. Supracondylar humeral fractures, often simply referred to as supracondylar. Pointbypoint, it is linked to the free citation guide, the indigo book. This is a basic article for medical students and other nonradiologists proximal femoral fractures are a heterogeneous group of fractures that occur in and around the hip. T1 clinical characteristics of severe supracondylar humerus fractures in children.
Describe necessary components of the physical exam of a child with a displaced supracondylar fracture 4. A temporary schanz pin blue bar was used to correct the rotational deformity. Proximal femoral fractures summary radiology reference. Supracondylar fractures of the humerus are a common pediatric elbow injury that can be associated with neurovascular complications and skeletal deformity. Fracture supracondylar humerus is one of the most common. Clinical characteristics of severe supracondylar humerus. Supracondylar fractures are a common elbow injury in children. Gartlands classification of supracondylar fracture of humerus galeazzi fracture a fracture of the radius with dislocation of the distal radioulnar joint colles fracture a distal fracture of the radius with dorsal posterior displacement of the wrist and hand smiths fracture a distal fracture of the.
Supracondylar humeral fractures, often simply referred to as supracondylar fractures, are a classic pediatric injury which require vigilance as imaging findings can be subtle. Standard treatments include open reduction and internal fixation. The most popular abbreviation for supracondylar fracture is. With a metal ruler and methylene blue, he drew a line extending the antecubital fold, which intersected. We advocate the ventral approach to this fracture as a logical, safe and elegant technique with low morbidity and with excellent anatomical and functional outcome. This study focus on the comparison between clinical and functional outcomes of fractures treated with condylar buttress plates cbps. Written by leading orthopaedic surgeons from around the world, the revised and expanded 8th edition of this classic bestselling text presents complete, uptodate coverage of all types of childrens fractures. With the recognised complications of cubitus varus, injury to any of the three major nerves around the elbow, absent radial pulse after fracture reduction, stiffness and the fortunately rare incidence of volkmanns ischaemic contracture, an appropriate understanding of the pathology and management of this. Temporal characteristics of paediatric supracondylar humerus.
Blind pinning of displaced supracondylar fractures of the humerus in children. Garg s, weller a, noelle larson a, fletcher nd, kwon m, schiller j et al. Supracondylar fracture is known as mullers type a subgroup of extraarticular fractures of distal femoral fractures 5. For the goldstandard resource on pediatric fractures, reach for rockwood and wilkins fractures in children. Supracondylar humeral fracture radiology reference article. Supracondylar fracture most common in children 311 y.
Keywords avulsion fractures casting and immobilization child abuse nonaccidental trauma nat distal humerus physeal separation distal femur physeal fracture pediatric hip dislocation pediatric hip fracture humeral shaft fractures lateral condyle fracture medial epicondyle fracture pediatric ankle fractures pediatric forearm fracture pediatric clavicle fracture pediatric distal radius. Whether they are transverse, oblique, or comminuted, supracondylar or intercondylar in a t, y or v fashion their management still evokes much controversy because of the consistently poor results obtained. Open reductions of paediatric supracondylar humerus fractures. Reprinted by the john charnley trust, the original text having been out of print for many years, this beautifully presented book deals very simply and scientifically with most of the difficult fractures an orthopaedic surgeon is likely to meet in hisher practice. Supracondylar fractures of the humerus sciencedirect. The most common fractures caused by osteoporosis are hip, spine, wrist and shoulder humerus fractures. Understanding the anatomy, radiographic findings, complications, and management options associated with this fracture allow physicians to limit the morbidity associated with this injury. May 10, 2008 supracondylar fractures of the humerus are a common pediatric elbow injury that can be associated with neurovascular complications and skeletal deformity. Arguably, hip fractures are the most catastrophic for sufferers and their families, and are the most costly to the health system. These fractures have got wide variety of fracture patterns and they are commonly associated with injuries such as.
Bilateral supracondylar humerus fracture in pediatric after a fall on. The wilkinsmodified gartland classification of pediatric supracondylar humerus fractures does not consider coronal or sagittal obliquity. Displaced supracondylar fracture without intracondylar extension of lower end of right femur, initial encounter for open fracture type i or ii. There is no clear evidence in the actual literature regarding which of the surgical approaches could bring about the best functional, cosmetic, and radiological outcomes, as well as fewer complications, when an open reduction and pinning of a severely displaced supracondylar humerus fracture is performed. Treatment of supraintercondylar aoota 33c and supracondylar aoota 33a femur fractures is generally challenging. To assess the results of treatment for flexiontype supracondylar humeral fracture in children. The closed treatment of common fractures john charnley. Treatment of pediatric supracondylar humerus fractures case study introduction supracondylar fractures of the humerus in children are the result of trauma to the elbow, most often resulting from a fall from a height or related to sports or leisure activities. Supracondylar fractures are classified into 3 main types based on the gartland system can be either extension or flexion type. Ranges of differences in the measurement of the baumann angles were established, and the percentage of agreement between observers was then calculated. Gartlands classification of supracondylar fracture of humerus.
But with supracondylar femoral fracture, the muscles in the thigh often contract and pull the bone pieces apart. How do you treat radial nerve injury with supracondylar fracture in children. Supracondylar fractures of the humerus are one of the most common fractures of childhood. Jan 05, 2012 fracture is a story of second chances, life and death, love and friendship. Distal humerus osteotomy for supracondylar fracture malunion. Supracondylar fracture of the humerus is the most common type of elbow fracture in children and adolescents. Pdf supracondylar fracture of the humerus in children. Describe a useful classification system for supracondylar fractures of the humerus 2. May 10, 2015 the supracondylar fracture of humerus demand great respect in treatment because its association with different types of complications we intend to study and evaluate methods of treatment and clinical outcome of fracture supracondylar humerus and evaluation of any shortcomings which causes secondary loss of reduction. Supracondylar humerus fracture, open reduction, surgical approach.
Simple supracondylar fractures are typically seen in younger children, and are uncommon in adults. Casts and braces may not work well with this type of fracture, unless it is stable and the bone pieces are well aligned. Citation machine helps students and professionals properly credit the information that they use. Together with the webbased national hip fracture database, the blue book offers guidance, standards of care, and feedback on care and outcomes, thus allowing trauma units to benchmark and improve their management of the most serious common osteoporotic injury. The purposes of our study were 1 to identify and describe fracture characteristics with unique properties and 2 to propose a fracture classification system that can be reproduced reliably. These fractures are more commonly seen in boys 4 these injuries are almost always due to accidental trauma, such as falling from a moderate height bedmonkeybars 4. As the most commonly fractured long bone, it is not surprising that the femur was the first bone in which internal fixation was attempted.
Before reading fracture i was confused about how this book is going be like, just another realistic fiction including some teen problems. The mustknow complications of supracondylar fractures em daily. Pediatric supracondylar fractures of the distal humerus. Distal femoral fractures account for about 7% of all femoral fracture 6. This post will introduce the types of supracondylar fractures and known complications. Nowadays closed reduction and percutaneous pinning has become standard of care for majority of displaced supracondylar humerus fractures. Supracondylar fracture of the humerus objectives 1.
Epidemiology simple supracondylar fractures are typically seen in yo. In the first group we included 56 children with supracondylar fracture gartland type iii, from august. Operative treatment of supracondylar fractures of the humerus in. It accounts for 5070% of elbow fractures and is seen most frequently in children between the age of 3 and 10 years blount there exists controversy about the optimal treatment modality for displaced supracondylar fractures. Management of fractures of distal femur journal of medical. Pediatric supracondylar fractures of the distal humerus ncbi.
These fractures are classified using the modified gartland. Treatment of flexiontype supracondylar humeral fracture. Despite the fact that the original text was published in 1950, the basic principles espoused in the book still apply today, and it. Type i fracture is not displaced or minimally displaced. Dear colleagues, in an attempt to expand the outreach of knowledge, we are now starting a special subscription offer for trauma international journal. Supracondylar fracture of the humerus is the most common. Describe useful radiographic parameters for assessing quality of reduction of supracondylar fractures 3. May 04, 2016 trauma international special subscription offer. Introduction supracondylar humerus fracture shf is one of the commonest fractures in pediatric elbow. This fact sheet details the care and management for a child with an undisplaced elbow fracture. A fracture that occurs in the humerus above the condyles. Epidemiological features of supracondylar fractures of the humerus in chinese children. The fracture is usually transverse or oblique and above the. Distal humerus osteotomy for supracondylar fracture malunion in children.
In general, casts and braces can hold fractured bones in place as you heal. As has been true of all editions released since 2010, it is also indexed to the the bluebook. Management of supracondylar fracture of humerus in children by close reduction and immobilization of the elbow in extension and supination iqtidar ullah babar, nowroz shinwari, mohammad rahim bangash, m shoaib khan department of orthopaedics, lady reading hospital peshawar, department of anatomy, khyber medical college, peshawar. Supracondylar fracture of the humerus is the second most common fracture in children 16. The commonest type of fracture in this region is the femoral neck fractur. Comparison of supraintercondylar and supracondylar femur. It accounts for 17% of all limb fractures in children 3,4. Clavier 3 analyzed several series and said that elbow fractures all types accounted for 16% of all pediatric fractures, and that the incidence of supracondylar fractures varied according to authors from 42 to 65%. Operative treatment of supracondylar fractures of the humerus in children. The blue book can be downloaded from this page pdf format, 73 pages. Patterns of pediatric supracondylar humerus fractures. Prospective study of managementof supracondylar fractures of. Aug 23, 2019 this angle was measured by five observers on ap radiographs of 35 elbows that had sustained a nondisplaced supracondylar humerus fracture.
Supracondylar and intercondylar fractures of the femur. About 4,000 people per annum suffer a hip fracture in new zealand. Supracondylar humerus fracture sch is common in the pediatric age group 57 years, mostly due to a fall on an outstretched hand. A supracondylar humerus fracture is a fracture of the distal humerus just above the elbow joint.
Using this method as a guide, we modified this technique so that a systematic. It usually occurs in the first decade of life with a peak incidence between the ages of 5 and 8 and prevalence in boys. Pdf distal humerus osteotomy for supracondylar fracture. We studied 450 children with a supracondylar fracture of the humerus in the period 1991 to 1995, and were able to collect full management details in 403 of them 253 boys and 150 girls. Cast immobilization if an extension type of fracture then consider initially splinting into a 20 degree elbow flexion. Your browser does not currently recognize any of the video formats available. Supracondylar fracture of humerus is very common in children it is also called malgaigne. However, if closed reduction fails aronson et al kwire fixation of supracondylar humerai fractures in children 181 after one or two attempts, open reduction should be performed. Management of supracondylar fractures of the humerus in children. Supracondylar humeral fracture radiology reference. Care of patients with fragility fracture blue book.
600 146 1015 1293 639 588 1436 891 599 111 186 1486 1175 670 986 1375 472 1270 542 1078 1327 325 309 1217 1494 398 273 718 1145