/pdf/fractures-and-dislocations-in-children-3q6l6rra0w.pdf

Fractures and Dislocations in Children

The current controversy regarding the management of fractures of the lateral condyle of the humerus presenting between 3 to 12 weeks prompted us to evaluate our results of open reduction and internal fixation of such fractures. Patients and Methods: Twenty-one patients operated between March 1995 and February 2001 qualified for this study. Five patients presented between 3–4 weeks, nine between 5–8 weeks and seven between 9–12 weeks post injury. Ten fractures were classified as stage II and eleven as stage III (Jacob et al. criteria). The mean age was 8 years (range: 4-14 years). All patients underwent surgery (open reduction and internal fixation with K-wires/screw, with or without bone grafting). The results were assessed by the modified criteria of Agarwal et al. after an average follow-up of 2.3 years. Excellent to good results were observed in all the five patients presenting at 3-4 weeks post injury. In the patients presenting at 5–8 weeks, the results were excellent in one, good in four, fair in three, and poor in one patient. The fracture united in all cases; however, malunion was observed in four patients. The fractures that were operated at 9-12 weeks showed good results in one case, fair result in three cases, and poor result in three cases. Avascular necrosis of the lateral condyle in one patient, premature fusion in two patients, pin tract infection in three patients, and gross restriction of elbow movements in three patients were the major complications in this group. Accurate reduction was difficult as a result of new bone formation and remodeling at the fracture surfaces. Multiple incisions over the common extensor aponeurosis and bone graft supplementation were helpful for achieving acceptable reduction. Open reduction and internal fixation is recommended in all cases of displaced fractures of the lateral condyle of the humerus presenting at up to 12 weeks post injury. However, the results become poorer with increase in duration after injury and the grade of displacement. To avoid complications it is important to carry out careful dissection of the soft tissue attachments and to mobilize the fragment without the use of force.

Late presentation of fractures of the lateral condyle of the humerus in children.

Purpose: To determine whether late open reduction and internal fixation (ORIF) of a lateral condylar fracture (LCF) after 3 weeks is possible, and to determine the latest time for ORIF without a bone graft. Materials and Methods: Eight children underwent late ORIF (＞3 weeks) of a displaced LCF (＞2.5 ㎜) of the humerus between 3 weeks and 5 weeks after injury. Results: Clinically, results were excellent in 6 cases and good in 2 cases. There was no serious complication, including nonunion and avascular necrosis (AVN), though 2 cases had a slight fishtail deformity and mild carrying angle loss due to overgrowth of the lateral condyle fragment. Conclusion: We believe that 3 weeks is too short to deny open reduction and anatomic reduction for fear of AVN of a late presented lateral condyle fracture of the humerus. The latest time for ORIF in late presented LCF in children is around 5 weeks, and surgical treatment may even be possible after greater delays.

/pdf/surgical-treatment-of-late-presented-displaced-lateral-1ppu3jt75p.pdf

Surgical Treatment of Late Presented Displaced Lateral Condylar Fracture of the Humerus in Children

Background: Delayed presentation of lateral condylar fractures of the humerus is relatively common in the developing regions of the world. Fractures of lateral condyle of humerus in pediatric age group, the most common being distal humerus epiphyseal injury, are commonly associated with delayed presentation to terminal health care providers. Materials and Methods: Twenty-one children having fracture of lateral condyle of humerus with duration of trauma more than 3 weeks were included in the prospective study. Among the 21 patients, 13 were male and 8 were female. Average time of presentation was after 3 weeks of injury. All patients had Milch type II injury. The patients were treated by open reduction and internal fixation using Kirschner wire. The outcome assessment according to the scoring system proposed by Dhillon et al. was used. Result: Mean month at operation is 81.5 months (range, 64-112 months); 8 Right/13 Left. Reason for presentation: Pain, swelling in 12; Pain, decreased elbow motion in 7; Restriction of the elbow flexion in 2. Time from injury to Operation with mean 6.34 weeks, 3 weeks-≤ 6 weeks in 13 Patients, and > 6 weeks in 8 patients; Previous treatment: Plaster cast in 15 Patients, and No treatment in 6 Patients; Mean time of Follow-up: 66 Months; Mean Age at last Follow-up was 11.6 (range, 8.4-15.0). To tell result, 38.1% is in Excellent; 33.3% is in Good; 14.3% is in Fair; and 14.3% is in Poor. Comparison of accepted result from time of injury to operation was 3-6 weeks better than over 6 weeks with P Valuate 0.001387. There were AVN in 1 case, Nonunion in 2 cases. Conclusion: Osteosynthesis by Kirschner wire without bone grafting could provide solid bony union and improve elbow function. However, this technique could not prevent an angular deformity completely. Corrective osteotomy should be considered in patients with valgus or varus deformities.

Kirschner Wire Fixation of Neglected Lateral Condylar Fracture of the Humerus in Children

We proposed a simple posterolateral approach to the articular surface of the trochlea for fresh and late fractures of the humeral lateral condyle. Twenty consecutive cases, 16 fresh and four old fractures, were approached between triceps and anconeus before the age of 15 years. All fractures achieved union in 3 months. Nineteen cases were classified as excellent or good by the Hardacre score after 31.3 months of follow-up. One late fracture with elbow subluxation showed radiographic fragmentation of the capitellum and a fair clinical result. This simple optional approach offers good exposure of intra-articular fracture at the trochlea, especially for late fractures.

Posterolateral approach for humeral lateral condyle fractures in children.

Background/Purpose: We questioned the principle of treatment of late lateral condylar fracture of a pediatric elbow We report the results of treating this condition using a different approach Methods: We treated six children with type 3 late lateral condylar fractures The average age was 45 years old The time delay from injury to surgery averaged at 38 months All the displaced lateral condyles were Milch type 2 with significant rotation away from the trochlea The articular anatomic reduction of the lateral condyles was achieved via ulnar osteotomy in all six cases We fixed both the fracture and the osteotomy with Kirschner wires buried under the skin No strenuous passive physical therapy was needed Results: All lateral condylar fractures and ulnar osteotomies were united within 3 months Five out of six children had regained full range of motion and symmetric carrying angles at the latest follow-up 2 to 11 years later Complications included transient physeal change and lateral bump Conclusion: Based on our results, we recommend olecranon osteotomy via a posterior approach as one of the options in treating late cases of type 3 lateral condylar fracture of the elbow with significant displacement in children

Anatomic reduction of old displaced lateral condylar fractures of the humerus in children via a posterior approach with olecranon osteotomy.

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

Wen-E Yang

Author Tools

Chat about Author

Papers

Anatomic reduction of old displaced lateral condylar fractures of the humerus in children via a posterior approach with olecranon osteotomy.