Short-term Follow-up of Early Reconstructive Surgery Management in Neglected Supracondylar Humeral Fractures
DOI:
https://doi.org/10.3889/oamjms.2021.5577Keywords:
Neglected supracondylar humeral fracture, Quick disabilities of the arm, shoulder, and hand-9 score, Flynn’s criteria, Mayo elbow performance score, Early reconstructive surgeryAbstract
BACKGROUND: The supracondylar humeral fracture is a fracture located in the proximal position of the trochlea and humeral capitulum. This fracture is the most common elbow fracture in children. Epidemiological research states that these fractures constitute 58% of all elbow fractures in children. It is also mentioned that 10–20% patients undergo belated admission to get therapy. Based on the literature, the fracture is categorized as neglected if the fracture treatment is 14 days post-trauma. Unfortunately, few reports can provide management guidelines. Some experts mention the “wait and see” attitude toward this fracture until a perfect remodeling happens to correct the deformity; however, a number of studies have shown good results after early reconstruction.
AIM: We aimed to evaluate the short-term follow-up of supracondylar humeral fractures that came after 14 days of injury and then open reduction reconstructions were done, followed by the installation of K-wire and screws with the figure of eight patterns based on the quick disabilities of the arm, shoulder, and hand (Q-DASH) 9-score, Flynn’s Criteria, and Mayo Elbow Performance Score (MEPS).
METHODS: The samples were five patients who underwent corrective open reduction and injury fixed with Kirschner (K)-wire and screws with the figure of eight patterns using the posterior approach at the Orthopedic Hospital from December 2019 to February 2020. Results were assessed with the quick disabilities of the arm, shoulder, and hand-9 score (Q-DASH-9 score), Flynn’s Criteria, and Mayo Elbow Performance Score (MEPS).
RESULTS: All patients after reconstruction correction showed an increase in range of motion in the fractured elbow. No complications were found from the surgical treatment.
CONCLUSIONS: Early reconstruction correction of patients with supracondylar humeral fractures gave satisfactory results based on the Q-DASH-9 Score, Flynn’s Criteria, and MEPS.
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Mazzini JP, Martin JR, Andres-Esteban EM. Surgical approaches for open reduction and pinning in severely displaced supracondylar humerus fractures in children: A systematic review. J Child Orthop. 2010;4(2):143-52. https://doi.org/10.1007/s11832-010-0242-1 PMid:21455471
Eren A, Melih G, Bülent E, Murat C. Delayed surgical treatment of supracondylar humerus fractures in children using a medial approach. J Child Orthop. 2008;2(1):21-7. https://doi.org/10.1007/s11832-007-0072-y PMid:19308599
Kazimoglu C, Cetin M, Sener M, Agus H, Kalanderer O. Operative management of Type III extension supracondylar fractures in children. Int Orthop. 2009;33(4):1089-94. https://doi.org/10.1007/s00264-008-0605-0 PMid:18597086
Sadiq MZ, Syed T, Travlos J. Management of grade III supracondylar fracture of the humerus by straight-arm lateral traction. Int Orthop. 2007;31(2):155-8. https://doi.org/10.1007/s00264-006-0168-x PMid:16783547
Oh CW, Park BC, Kim PT, Park IH, Kyung HS, Ihn JC. Completely displaced supracondylar humerus fractures in children: Results of open reduction versus closed reduction. J Orthop Sci. 2003;8(2):137-41. https://doi.org/10.1007/s007760300023 PMid:12665947
Kow RY. Surgical management of paediatric neglected humeral supracondylar fracture: A series of 3 cases in 3 years. Int J Allied Health Sci. 2019;3(3):783.
Guo M, Xie Y, Su Y. Open reduction of neglected supracondylar humeral fractures with callus formation in children. J Pediatr Orthop. 2020;40(8):e703-7. https://doi.org/10.1097/bpo.0000000000001518 PMid:32011548
Kozin SH, Abzug JM, Safier S, Herman MJ. Complications of pediatric elbow dislocations and monteggia fracture-dislocations. Instr Course Lect. 2015;64:493-8. PMid:25745932
Putnam M, Christophersen C, Adams J. Pilot report: Non-operative treatment of mayo Type II olecranon fractures in any-age adult patient. Shoulder Elbow. 2017;9(4):285-91. https://doi.org/10.1177/1758573217711889 PMid:28932286
Kwok IH, Silk ZM, Quick TJ, Sinisi M, MacQuillan A, Fox M. Nerve injuries associated with supracondylar fractures of the humerus in children: Our experience in a specialist peripheral nerve injury unit. Bone Joint J. 2016;98-B(6):851-6. https://doi.org/10.1302/0301-620x.98b6.35686 PMid:27235532
Vaquero-Picado A, González-Morán G, Moraleda L. Management of supracondylar fractures of the humerus in children. EFORT Open Rev. 2018;3(10):526-40. https://doi.org/10.1302/2058-5241.3.170049 PMid:30662761
Li J, Rai S, Tang X, Ze R, Liu R, Hong P. Surgical management of delayed Gartland Type III supracondylar humeral fractures in children: A retrospective comparison of radial external fixator and crossed pinning. Medicine (Baltimore). 2020;99(10):e19449. https://doi.org/10.1097/md.0000000000019449 PMid:32150100
Farrow L, Ablett AD, Mills L, Barker S. Early versus delayed surgery for paediatric supracondylar humeral fractures in the absence of vascular compromise: A systematic review and meta-analysis. Bone Joint J. 2018;100-B(12):1535-41. https://doi.org/10.1302/0301-620x.100b12.bjj-2018-0982.r1 PMid:30499316
Tomori Y, Nanno M, Takai S. Clinical results of closed versus mini-open reduction with percutaneous pinning for supracondylar fractures of the humerus in children. Medicine (Baltimore). 2018;97(45):e13162. https://doi.org/10.1302/0301-620x.100b12.bjj-2018-0982.r1 PMid:30407346
Prashant K, Lakhotia D, Bhattacharyya TD, Mahanta AK, Ravoof A. A comparative study of two percutaneous pinning techniques (lateral vs medial-lateral) for Gartland Type III pediatric supracondylar fracture of the humerus. J Orthop Traumatol. 2016;17(3):223-9. https://doi.org/10.1007/s10195-016-0410-2 PMid:27312248
Carter CT, Bertrand SL, Cearley DM. Management of pediatric Type III supracondylar humerus fractures in the United States: Results of a national survey of pediatric orthopaedic surgeons. J Pediatr Orthop. 2013;33(7):750-4. https://doi.org/10.1097/bpo.0b013e31829f92f3 PMid:24025582
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Copyright (c) 2021 Tito Sumarwoto, Seti Aji Hadinoto, Herlambang Pranandaru, Hanif Andhika, Сholahuddin Рhatomy, Pamudji Utomo (Author)
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