RESUMEN
BACKGROUND: Paediatric supracondylar fractures are the most common childhood fractures under 8 years of age. Displaced paediatric supracondylar fractures are mostly classified on the basis of fracture geometry and none of the classification systems takes the clinical condition of the limb into consideration. OBJECTIVE: The purpose of this study was to evaluate the functional outcome of displaced extention type supracondylar fractures of humerus in children managed on the basis of our new classification. MATERIAL AND METHODS: A total of 207 children with displaced extention type supracondylar fractures of humerus were classified as per our classification system into simple and complex types, They were managed and followed over a mean period of 24 weeks, and the results were recorded at the final follow-up. RESULTS: We had 175 simple and 32 complex fractures. There was a significant difference in mean surgical time between simple (19.64 ± 3.52 min) and complex fractures (43.41 ± 27.07 min). Mean duration of hospital stay was significantly lower in simple fractures (1.02 ± 0.31 days) as compared to complex fractures (2.62 ± 1.84 days). Out of 175 patients in simple group 167 (95.4%) had excellent result,6 (3.4%) had good result 1 (0.6%) had fair result and 1 (0.6%) had poor result whereas out of 32 patients in complex group 10 (31.3%) had excellent result, 5 (15.6%) had good result, 11 (34.4%) had fair result and 6 (18.8) had poor result. Overall results were better in simple group as compared to complex group as per Flynn criteria. CONCLUSIONS: Management of patients with displaced supracondylar fractures of humerus using Barza classification in emergency room gives good result and gives an idea about management and prognosis.
RESUMEN
Removal of foreign bodies from soft tissues in emergency is very challenging and becomes more problematic when it is radiolucent. Blind exploration is sometimes hazardous for patients especially when it is in proximity to a vessel or a nerve or an overlying tendon. The purpose of this study was to determine the accuracy of ultrasonography (USG) in detecting radiolucent soft tissue foreign bodies in the extremities. From January 2014 to January 2016, 120 patients with either a positive history or clinically suspected soft tissue foreign body and negative radiography were evaluated by USG with a high-frequency (13-6 MHz) linear-array transducer. The sonographic findings were used to guide surgical exploration. Out of 120 patients who underwent surgical exploration, USG was positive in 114 cases, and foreign body was retrieved in 108 cases, and among the six cases where USG was negative, foreign body was retrieved from one case. In one case with strong clinical suspicion of foreign body USG was falsely negative. Majority of foreign bodies were removed from foot (69 cases) and hands (26 cases), and rest of foreign bodies were removed from ankle (4 cases), wrist (3 cases), thigh (2 cases), leg (1 case), knee (2 cases), forearm (2 cases). Accuracy, sensitivity, and positive predictive value were determined as 94.16, 99.08, and 94.13%, respectively. The real-time high-frequency USG is a highly sensitive and accurate tool for detecting and removing radiolucent foreign bodies which cannot be visualized by routine radiography.
RESUMEN
Floating arm injury represents a common yet complicated injury of the childhood severely associated with limb deformation and even morbidity, if not precisely addressed and credibly operated. Here, we report a rare floating upper limb case of a 9-year-old boy with multiple injuries of ipsilateral proximal humeral, supracondylar and distal radial limb. This is the first report to document such a combined floating elbow and floating arm injury in the same limb. In this report, we discuss the surgical procedures used and recovery of the patient monitored to ascertain the effectiveness of the method in limb reorganisation.