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Objective To evaluate the clinical efficacy of arthrography in the treatment of lateral condylar fracture of humerus with displacement of ≤ 2 mm in children.Methods A retrospective study was performed in the 21 children with lateral condylar fracture of humerus who had received arthrography in their surgery at Department of Pediatric Orthopedics,Honghui Hospital,Xi'an Jiaotong University College of Medicine from April 2015 to December 2016.They were 14 boys and 7 girls,aged from 5 to 12 years (average,8.6 years).Their primary diagnosis was made within one week from injury and they all had a displacement of ≤ 2 mm.Of them,2 were treated by plaster fixation because intraoperative arthrography found no fracture of articular cartilage (group A),11 by simple closed pining because intraoperative arthrography found fracture of articular cartilage involving the joint space (group B),and 8 by open reduction and fixation with kirschner wire because intraoperative arthrography found displacement of the involved articular surface (group C).The therapeutic efficacy was evaluated at final follow-ups by the Dhillon scoring system.Results All the 21 children were followed up from 9 to 23 months (average,16 months).The fracture union time ranged from 8 to 10 weeks (average,9 weeks) for groups A and B and from 11 to 13 weeks (average,12 weeks) for group C.By the Dhillon scores at final follow-ups,the therapeutic efficacy was evaluated as excellent in one and as good in one in group A,as excellent in 8 cases,as good in 2 cases and as fair in one in group B,and as excellent in 6 cases,as good in one and as fair in one in group C.No early closure of epiphysis,osteonecrosis or fishtail deformity was found in either group A or group B;one case of partial limitation of elbow flexion or extension,one case of fishtail deformity and one case of femoral head necrosis were observed in group C.No infection or skin necrosis was found in any of the 3 groups.Conclusions Because intraoperative arthrography can definitely judge whether the articular surface is intact or unstable,it can make up for the insufficiency of X-rays in judging integrity of the articular surface.In combination with closed reduction,percutaneous puncture or open reduction and internal fixation,intraoperative arthrography can contribute to an increased rate of successful surgery,and reduced complications due to redisplacement.
ABSTRACT
PURPOSE: The purpose of this study was to compare the changes in patients pattern retrospectively for pediatric supracondylar and lateral condylar humeral fractures. MATERIALS AND METHODS: We retrospectively studied 335 pediatrics treated operatively for supracondylar and lateral condylar fracture from March 1993 to February 2013. The pediatrics were divided depending on the 10-year time period: those who received treatment from March 1993 to February 2003 as group I, and those who received treatment from March 2003 to February 2013 as group II. By each group, the differences in age, gender, cause, season of incidence, whether the time of incidence was a weekend, and education level of the parents were compared and analyzed. RESULTS: Fractures in group I were mainly due to slip down and fall down, but sports injury was the main cause of fractures in group II. There were 112 cases and 121 cases of supracondylar fractures, and 65 cases and 37 cases of lateral condylar fracture in groups I and II. Significant differences were found in the incidence of lateral condylar facture (p=0.009). In terms of the education level of the parents, the number with high school or under decreased significantly from group I to group II, from 71 cases to 45 cases (p=0.040). CONCLUSION: The supracondylar fracture does not show any significant difference according to the time lapse in the age and cause of incidence. However, the incidence of lateral condylar fracture shows a decreasing trend which may be related to the decrease of the incidence of slipping and falling, and the improvement in the parent's education level.
Subject(s)
Humans , Athletic Injuries , Education , Humeral Fractures , Humerus , Incidence , Parents , Pediatrics , Retrospective Studies , SeasonsABSTRACT
PURPOSE: To compare the results of open fixation and closed percutaneous pinning in managing Jakob stage II lateral condylar fractures of children's elbow. MATERIALS AND METHODS: Since Febuary 2000, We operated 21 children with Jakob stage II lateral condylar fractures of elbow. Eleven of the 21 were treated with closed percutaneous pinning, open fixation was done to the other 10 children. Each patient was evaluated about range of motion, carrying angle, scar satisfaction and radiologic findings for comparison between closed pinning and open fixation groups. RESULTS: Open fixation group showed 3.8 degrees decrease of elbow motion while closed pinning group showed no significant decrease. Carrying angle and radiologic findings were not different between the two groups. Open fixation group expressed dissatisfaction to their scars (average 5.2 cm) whereas all the patients of closed pinning group were satisfied with their functional and cosmetic outcomes. CONCLUSION: In managing Jakob stage II lateral condyle fractures of children's elbow, closed percutaneous pinning was thought to be superior to open fixation because of the same functional outcome and much better cosmetic results.
Subject(s)
Child , Humans , Cicatrix , Elbow , Range of Motion, ArticularABSTRACT
PURPOSE: To analyze the correlation of various factors by examining the epidemiology of lateral condylar fracture of the humerus which is the second most fracture among elbow fractures in children. MATERIALS AND METHODS: Of 158 cases treated for lateral condylar fracture of the humerus in children from April 1996 to March 2006, their age and sex distribution, the seasonal frequency, etiology, type of fracture, method of treatment, etc. were analyzed retrospectively. RESULTS: Boys were 113 cases, girls were 45 cases, and the mean age was 5.4 years. Regarding the seasonal occurrence, spring 43 cases, summer 44 cases, autumn 48 cases, and winter 23 cases had occurred. It occurred preferentially during the season when outdoor activity was most active. As its etiology, the accident in a playground was 39 cases, sports activity was 32 cases, traffic accident was 17 cases, slipping accident at home was 15 cases, falling accident at home was 14 cases, slip while playing with friends was 6 cases, a missing step while walking on stairs was 6 cases, fall from a height more than 2 floors was 4 cases, and the cases with unknown cause were 25 cases. According to the Jakob stage, the stage I was 42 cases, the stage II 77 cases, and the stage III was 39 cases. As treatment, cast immobilization was performed in 34 cases, closed reduction and percutaneous K-wire fixation was performed in 68 cases, and open reduction and K-wire fixation was performed in 56 cases. The prevalent causalities were play devices, accident during sports activity, and traffic accident, and in such cases, the displacement of fracture was severe and thus surgical treatments were performed in many cases (94%). CONCLUSION: It is thought that during the season when outdoor action is active, particularly, for kindergarten children or the lower grade primary school children, safety education is required to prevent the fracture by play devices, sports activity and traffic accident.