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Wang Y, Chong Q, Zhang S, Ben Y, Li Q, Chen D, Zheng P. Analysis of risk factors for failed closed reduction in pediatric Gartland Type III supracondylar humerus fracture. J Shoulder Elbow Surg 2024; 33:2279-2289. [PMID: 38852708 DOI: 10.1016/j.jse.2024.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 04/12/2024] [Accepted: 04/18/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND Gartland Type III supracondylar humerus fractures (SCHFs) are commonly treated using closed reduction followed by percutaneous pin fixation. However, conversion to open reduction may be necessary if closed reduction fails. This study aimed to identify risk factors associated with failed closed reduction and provide a theoretical basis for clinical decision-making in the treatment of Gartland Type III fractures. METHODS A retrospective analysis was conducted on children with Gartland Type III SCHF who underwent surgical treatment between April 2017 and June 2018. Based on whether or not the closed reduction was successful, patients were split into the open reduction group and the closed reduction group. Within the closed reduction group, subgroup analysis based on surgery duration was carried out. Data were collected from medical records and X-ray images. Univariate and multivariate regression analyses were utilized to evaluate the relationship between variables and failed closed reduction. RESULTS The study included 36 patients in the open reduction group and 135 patients in the closed reduction group. Multivariate analysis revealed that the presence of angle (P = .024, OR = 3.199), rotation (P = .000, OR = 6.359), skin creases (P = .013, OR = 4.077), anterior-posterior displacement ratio (P = .011, OR = 4.337), fracture angle in the anteroposterior view (P = .014, OR = 0.939), and fracture distal displacement direction (P = .002, OR = 5.384) were independent risk factors for failed closed reduction. Subgroup analysis showed that fracture distal displacement direction (P = .013), skin folds (P = .013), lateral displacement ratio (P = .016), and anterior-posterior displacement value (P = .005) significantly influenced the duration of closed reduction surgery. CONCLUSION The presence of sharp angle or rotation at the fracture ends, skin folds on the anterior elbow, minor anterior-posterior displacement of the fracture, higher medial inclination of the fracture plane, and distal fracture displacement toward the radial side are independent risk factors for failed closed reduction in pediatric Gartland Type III SCHF.
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Affiliation(s)
- Yiwei Wang
- Department of Orthopedics surgery, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, Republic of China
| | - Qingqing Chong
- Department of Orthopedics surgery, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, Republic of China
| | - Shengnan Zhang
- Department of Orthopedics surgery, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, Republic of China
| | - Yulong Ben
- Department of Orthopedics surgery, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, Republic of China
| | - Qiang Li
- Department of Orthopedics surgery, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, Republic of China
| | - Dan Chen
- Department of Orthopedics surgery, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, Republic of China.
| | - Pengfei Zheng
- Department of Orthopedics surgery, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, Republic of China.
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Hahn SG, Schuller A, Pichler L, Hohensteiner A, Sator T, Bamer O, Chocholka B, Jaindl M, Schwendenwein E, Parajuli B, Rapole S, Tiefenboeck T, Payr S. Complications and Outcomes of Surgically Treated Pediatric Supracondylar Humerus Fractures. CHILDREN (BASEL, SWITZERLAND) 2024; 11:791. [PMID: 39062240 PMCID: PMC11276334 DOI: 10.3390/children11070791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 06/22/2024] [Accepted: 06/26/2024] [Indexed: 07/28/2024]
Abstract
This study describes the outcome of supracondylar humerus fractures in children using crossed K-wires after closed or open reduction with the medial, lateral or bilateral approach. Patients treated between January 2000 and December 2019 were classified according to the Von Laer classification, complications were classified according to the Sink classification and clinical outcomes were classified according to modified Flynn criteria. In total, 364 patients with a mean age of 5.23 ± 2.45 years were included. The majority were type IV fractures (156; 42.9%) and 94 (60.3%) needed an open reduction for which the medial approach (53; 56.4%) was predominantly used. Overall, of 50 complications (31 using closed reduction, 19 open reduction), 17/50 (34%) needed revision surgery. An excellent clinical outcome was achieved in 348/364 (95.6%) patients. The approach used for open reduction as such had no influence on the complication rate or clinical outcome. For severely displaced fractures, the data showed that an open approach for crossed K-wires tended to result in fewer complications and better clinical outcomes than a closed reduction. If an open reduction is indicated, the required approach (medial, lateral or bilateral) should be primarily selected according to the requirements of the fracture pattern and eventual cosmetic considerations.
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Affiliation(s)
- Sebastian G. Hahn
- Department of Trauma Surgery, University Clinic of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria; (S.G.H.); (A.S.); (L.P.); (A.H.); (T.S.); (O.B.); (B.C.); (M.J.); (E.S.); (T.T.)
| | - Andrea Schuller
- Department of Trauma Surgery, University Clinic of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria; (S.G.H.); (A.S.); (L.P.); (A.H.); (T.S.); (O.B.); (B.C.); (M.J.); (E.S.); (T.T.)
| | - Lorenz Pichler
- Department of Trauma Surgery, University Clinic of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria; (S.G.H.); (A.S.); (L.P.); (A.H.); (T.S.); (O.B.); (B.C.); (M.J.); (E.S.); (T.T.)
| | - Anna Hohensteiner
- Department of Trauma Surgery, University Clinic of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria; (S.G.H.); (A.S.); (L.P.); (A.H.); (T.S.); (O.B.); (B.C.); (M.J.); (E.S.); (T.T.)
| | - Thomas Sator
- Department of Trauma Surgery, University Clinic of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria; (S.G.H.); (A.S.); (L.P.); (A.H.); (T.S.); (O.B.); (B.C.); (M.J.); (E.S.); (T.T.)
| | - Oskar Bamer
- Department of Trauma Surgery, University Clinic of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria; (S.G.H.); (A.S.); (L.P.); (A.H.); (T.S.); (O.B.); (B.C.); (M.J.); (E.S.); (T.T.)
| | - Britta Chocholka
- Department of Trauma Surgery, University Clinic of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria; (S.G.H.); (A.S.); (L.P.); (A.H.); (T.S.); (O.B.); (B.C.); (M.J.); (E.S.); (T.T.)
- Section of Pediatric Trauma Surgery, Department of Trauma Surgery, University Clinic of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria
| | - Manuela Jaindl
- Department of Trauma Surgery, University Clinic of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria; (S.G.H.); (A.S.); (L.P.); (A.H.); (T.S.); (O.B.); (B.C.); (M.J.); (E.S.); (T.T.)
- Section of Pediatric Trauma Surgery, Department of Trauma Surgery, University Clinic of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria
| | - Elisabeth Schwendenwein
- Department of Trauma Surgery, University Clinic of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria; (S.G.H.); (A.S.); (L.P.); (A.H.); (T.S.); (O.B.); (B.C.); (M.J.); (E.S.); (T.T.)
- Section of Pediatric Trauma Surgery, Department of Trauma Surgery, University Clinic of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria
| | - Bikash Parajuli
- Department of Orthopedics and Traumatology, Dhulikhel Hospital, Kathmandu University Hospital, Kavre, Nepal;
| | - Sanika Rapole
- Department of Pediatric Orthopedics, Sancheti Institute for Orthopedics and Rehabilitation, Pune, India;
| | - Thomas Tiefenboeck
- Department of Trauma Surgery, University Clinic of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria; (S.G.H.); (A.S.); (L.P.); (A.H.); (T.S.); (O.B.); (B.C.); (M.J.); (E.S.); (T.T.)
| | - Stephan Payr
- Department of Trauma Surgery, University Clinic of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria; (S.G.H.); (A.S.); (L.P.); (A.H.); (T.S.); (O.B.); (B.C.); (M.J.); (E.S.); (T.T.)
- Section of Pediatric Trauma Surgery, Department of Trauma Surgery, University Clinic of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria
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Wang Q, Wang Y, He M, Cao H, Zhao J. Research: Construction and validation of elbow function prediction model after supracondylar humerus fracture in children. Medicine (Baltimore) 2023; 102:e36775. [PMID: 38206691 PMCID: PMC10754596 DOI: 10.1097/md.0000000000036775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 12/04/2023] [Indexed: 01/13/2024] Open
Abstract
This article's objectives are to develop a model to predict children's recovery of elbow function following supracondylar fracture, analyze the risk factors affecting those children's elbow function after surgery, and propose a individualized treatment strategy for elbow function in various children. We retrospectively analyzed clinical data from 410 children with supracondylar humerus fracture. A modeling set and a validation set of kids in the included studies were arbitrarily split into 2 groups on a 7:3 basis. To identify statistically significant risk factors, univariate logistic regression analysis was used. Then, multivariate logistic regression was used with the risk factors, and the best logistic regression model was chosen based on sensitivity and accuracy to create a nomogram; A total of 410 children were included in the study according to the inclusion criteria. Among them, there were 248 males and 162 females, and the fracture type: 147 cases of type IIb and 263 cases of type III. There were no significant changes in the afflicted limb's lateral difference, surgical method, onset season, and number of K-wires, according to univariate logistic regression analysis. Age (P < .001), weight (P < .001), height (P < .001), preoperative elbow soft tissue injury (OR = 1.724, 95% CI: 1.040-2.859, P = .035), sex (OR = 2.220, 95% CI: 1.299-3.794, P = .004), fracture classification (Gartland IIb) (OR = 0.252, 95% CI: 0.149-0.426, P < .001), no nerve injury before surgery (OR = 0.304, 95% CI: 0.155-0.596, P = .001), prying technique (OR = 0.464, 95% CI: 0.234-0.920, P = .028), postoperative daily light time > 2 hours (OR = 0.488, 95% CI: 0.249-0.955, P = .036) has a significant difference in univariate analysis; Multivariate regression analysis yielded independent risk factors: fracture classification; No nerve injury before surgery; The daily light duration after surgery was > 2 hours; soft tissue injury; Age, postoperative cast fixation time. The establishment of predictive model is of significance for pediatric orthopedic clinicians in the daily diagnosis and treatment of supracondylar humerus fracture.
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Affiliation(s)
- Qian Wang
- Department of Orthopedics, Affiliated Hospital of Chengde Medical University, Chengde, Hebei, P. R. China
| | - Yu Wang
- Department of Orthopedics, Affiliated Hospital of Chengde Medical University, Chengde, Hebei, P. R. China
| | - Man He
- Department of Rehabilitation, Affiliated Hospital of Chengde Medical University, Chengde, Hebei, P. R. China
| | - Haiying Cao
- Department of Orthopedics, Affiliated Hospital of Chengde Medical University, Chengde, Hebei, P. R. China
| | - Jingxin Zhao
- Department of Orthopedics, Affiliated Hospital of Chengde Medical University, Chengde, Hebei, P. R. China
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Calogero V, Aulisa AG, Careri S, Masci G, Mastantuoni G, Falciglia F, Toniolo RM. Evaluation of Gartland Classification, Baumann Angle and Anterior Humeral Line in Paediatrics Supracondylar Fractures: An Inter and Intra-Observer Reliability Study. J Clin Med 2023; 13:167. [PMID: 38202175 PMCID: PMC10779671 DOI: 10.3390/jcm13010167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/19/2023] [Accepted: 12/24/2023] [Indexed: 01/12/2024] Open
Abstract
Supracondylar fractures of the humerus are frequent paediatric injuries. The aims of this study were to evaluate the applicability and reproducibility of the Gartland and Wilkins classification, the Baumann angle (BA) and the Anterior Humeral Line (AHL). This retrospective monocentric observational study was conducted on 217 patients. Four observers assessed the pre-operative radiographs by applying the Gartland and Wilkins classification and the post-operative X-rays by measuring the BA and AHL. The kappa coefficient (K) and the Cohen's kappa were used for the reliability of the Gartland classification; the Intraclass Correlation Coefficient (ICC) for that of the BA. The AHL was evaluated in a double manner by using first the K and the Cohen's kappa and then the ICC. A total of 186 patients were eligible. Inter-observer reliability for the Gartland classification was K = 0.73-0.61 for type III, 0.65-0.61 for type Ia and 0.43-0.26 for type IIb. The Baumann angle mean value in the first data collection was 73.5 ± 6.85 (inter-observer ICC 0.74) and 72.9 ± 6.83 (inter-observer ICC 0.77) for the second data collection; AHL: inter-observer ICC 0.87 for the first evaluation and 0.80 for the second one. Gartland's classification modified by Wilkins has a high degree of reliability. BA and AHL appear reproducible and reliable.
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Affiliation(s)
- Valeria Calogero
- U.O.C Traumatology, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (A.G.A.); (S.C.); (G.M.); (G.M.); (F.F.); (R.M.T.)
| | - Angelo Gabriele Aulisa
- U.O.C Traumatology, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (A.G.A.); (S.C.); (G.M.); (G.M.); (F.F.); (R.M.T.)
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, 03043 Cassino, Italy
| | - Silvia Careri
- U.O.C Traumatology, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (A.G.A.); (S.C.); (G.M.); (G.M.); (F.F.); (R.M.T.)
| | - Giulia Masci
- U.O.C Traumatology, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (A.G.A.); (S.C.); (G.M.); (G.M.); (F.F.); (R.M.T.)
| | - Giuseppe Mastantuoni
- U.O.C Traumatology, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (A.G.A.); (S.C.); (G.M.); (G.M.); (F.F.); (R.M.T.)
| | - Francesco Falciglia
- U.O.C Traumatology, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (A.G.A.); (S.C.); (G.M.); (G.M.); (F.F.); (R.M.T.)
| | - Renato Maria Toniolo
- U.O.C Traumatology, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (A.G.A.); (S.C.); (G.M.); (G.M.); (F.F.); (R.M.T.)
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Ma HL, Sun XW, Liu F, Hua ZT, Sun J, Zhang SC. Kirschner wire reconstruction of medial and lateral column periosteal hinge in the treatment of multidirectionally unstable supracondylar fracture of the humerus in children. Eur J Med Res 2023; 28:585. [PMID: 38082369 PMCID: PMC10714489 DOI: 10.1186/s40001-023-01560-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
AIM AND OBJECTIVE To compare the clinical effect of reconstruction of internal and lateral column periosteal hinge-assisted treatment with Kirschner wire and internal fixation with Kirschner wire in the treatment of multidirectional unstable supracondylar fractures of humerus in children. METHODS A retrospective cohort study was conducted to analyze the clinical data of 48 patients (31 male, 17 female; mean age: 6.7 ± 2.4 years old) with multidirectionally unstable supracondylar fractures of the humerus treated in our Hospital from August 2020 to August 2022. Twenty-five cases were treated with Kirschner wire reconstruction of the internal and lateral column periosteal hinge assisted by closed reduction and Kirschner wire internal fixation (study group). Twenty-three cases were treated with closed reduction and Kirschner wire internal fixation (control group). The operation time, intraoperative fluoroscopy times, percentage of patients who underwent open reduction after failure of closed reduction, fracture healing time, Baumann angle (BA), shaft-condylar angle (SCA), range of motion (ROM), and Flynn score of elbow at the last follow-up were compared between two groups. Complications such as infection and irritation of Kirschner wire tail were observed in two groups 2 months after the operation. RESULTS All patients were followed up for 10-22 months ([13.85 ± 2.89] months). The average operation time of the control group was 82.1 min, which was significantly longer than that of the study group 32.3 min (P < 0.05). The number of intraoperative fluoroscopy (29.4 ± 9.2) in the control group was significantly higher than that in the study group (15.2 ± 6.3) (P < 0.05). The incision rate of the control group was 17% while that of the study group was 0 (P < 0.05). According to Flynn score, the excellent and good rate of the elbow joint in the control group was 86.9% (20/23). The excellent and good rate of the elbow joint in the study group was 92.0% (23/25) (P > 0.05). There was no significant difference in fracture healing time, BA, SCA, and ROM between the two groups (P > 0.05). No infection or Kirschner wire tail irritation occurred in the two groups during the 2-month follow-up. CONCLUSION Reconstruction of internal and lateral periosteal hinges with Kirscher wire has similar effects to closed reduction and Kirschner wire fixation in the treatment of multidirectionally unstable supracondylar fractures of the humerus in children, but it can shorten the operation time and reduce intraoperative fluoroscopy times and incision rate.
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Affiliation(s)
- Hai-Long Ma
- Department of Pediatric Orthopedics, Anhui Provincial Children's Hospital (Children's Hospital of Anhui Medical University), No. 39 Wangjiang East Road, Hefei, 230051, Anhui, People's Republic of China
| | - Xi-Wei Sun
- Department of Pediatric Orthopedics, Anhui Provincial Children's Hospital (Children's Hospital of Anhui Medical University), No. 39 Wangjiang East Road, Hefei, 230051, Anhui, People's Republic of China
| | - Fang Liu
- Department of Pediatric Orthopedics, Anhui Provincial Children's Hospital (Children's Hospital of Anhui Medical University), No. 39 Wangjiang East Road, Hefei, 230051, Anhui, People's Republic of China
| | - Zhong Tuo Hua
- Department of Pediatric Orthopedics, Anhui Provincial Children's Hospital (Children's Hospital of Anhui Medical University), No. 39 Wangjiang East Road, Hefei, 230051, Anhui, People's Republic of China
| | - Jun Sun
- Department of Pediatric Orthopedics, Anhui Provincial Children's Hospital (Children's Hospital of Anhui Medical University), No. 39 Wangjiang East Road, Hefei, 230051, Anhui, People's Republic of China
| | - Si-Cheng Zhang
- Department of Pediatric Orthopedics, Anhui Provincial Children's Hospital (Children's Hospital of Anhui Medical University), No. 39 Wangjiang East Road, Hefei, 230051, Anhui, People's Republic of China.
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Pechlivanidou E, Antonopoulos I, Margariti RE. Gender equality challenges in orthopaedic surgery: a systematic review. INTERNATIONAL ORTHOPAEDICS 2023; 47:2143-2171. [PMID: 37433883 DOI: 10.1007/s00264-023-05876-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 06/20/2023] [Indexed: 07/13/2023]
Abstract
PURPOSE Several studies have examined gender-equality challenges and ways to improve women's representation and management. Orthopaedic surgeons and patients are less gender equitable than them of other surgical disciplines. This systematic review summarizes these findings and highlights orthopaedic surgery gender inequality. METHODS Search of the PubMed, Embase, and Cochrane databases was carried out to extract human studies investigating the gender gap in orthopaedics, trying to highlight the equality challenges orthopaedic surgery faces. Studies incorporating patients with comorbidities in which gender is a proven risk factor, and pregnant women were excluded. RESULTS This systematic review included 59 studies involving 692,435 people (mean females/males ratio: 4.44), spanning the years 1987-2023. Regarding the targeted population, 35 (59.32%) studies focused on patients, while 24 (40.68%) on physicians. Orthopaedic surgery is described as an unfriendly career field for women as surgeons or sports leading physicians while women are generally under represented in the academic field of orthopaedics. Regarding patients, female gender consists both a risk and prognostic factor influencing the prevalence of degenerative disease and the outcome of the operative treatment in reconstructive orthopaedics. Female gender is a risk factor for multiple sports injuries and influences the pathogenetic mechanisms resulting in ACL reconstruction. Regarding spine surgery, women are less likely to have surgery suggested, and such suggestion underlines severe disease's progression. CONCLUSIONS Gender differences affect orthopaedic patient-physician-healthcare system interactions. Recognizing biases and their patterns is useful to improve the actual situation. By preventing those an unbiased, tolerant, and egalitarian workplace for physicians and a healthcare system that provides the best treatment to patients could be created.
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Affiliation(s)
- Evmorfia Pechlivanidou
- 1st Department of Orthopaedics, P. & A. Kyriakou Children's Hospital, Athens, Greece.
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
| | - Ioannis Antonopoulos
- Department of Anatomy, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Rodanthi E Margariti
- 1st Department of Orthopaedics, P. & A. Kyriakou Children's Hospital, Athens, Greece
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Schuller A, Hahn S, Pichler L, Hohensteiner A, Sator T, Jaindl M, Schwendenwein E, Tiefenboeck T, Payr S. Correlation of Fall Height, Fracture Severity and Clinical Outcome in Pediatric Supracondylar Fractures—A Retrospective Analysis with an Observation Period of 20 Years. CHILDREN 2023; 10:children10030510. [PMID: 36980068 PMCID: PMC10047500 DOI: 10.3390/children10030510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 03/08/2023]
Abstract
The most common cause leading to supracondylar humerus fractures in children is falling onto an outstretched arm. A correlation between fall height and fracture severity may be assumed but has not yet been described. The aim of this study was to show that fracture severity increases with fall height. Furthermore, the correlation between fracture severity and outcome was examined. A total of 971 children with supracondylar humerus fractures between January 2000 and December 2019 were included in this study. The correlations between fall height and fracture severity and between fracture severity and outcome were assessed. Increasing fall height correlates with fracture severity (p < 0.001; r = 0.24). Furthermore, the incidence of complications increases with fracture severity and a correlation was present accordingly (p < 0.001; r = 0.28). A total of 30 (3.1%) patients showed limitations in range of motion and/or persistent neurologic deficits at the latest follow-up. Type I fractures rarely lead to subsequent limitations. The correlation between increasing fall height and fracture severity was significant. Furthermore, children with type III and IV supracondylar fractures are more likely to develop complications or restrictions in movement than children with type I and II fractures. Hence, the initial fall height may be an indirect indicator of a more or less favorable outcome.
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Sibanda V, Raad M, Legg PI, Chipperfield A, Oliver MC. Quality of Documentation in Paediatric Supracondylar Fractures: A Quality Improvement Project. Cureus 2022; 14:e31431. [DOI: 10.7759/cureus.31431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2022] [Indexed: 11/15/2022] Open
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Akgülle AH, Şahbat Y, Baysal Ö, Kart H, Erol B. Supracondylar Humerus Fractures in Infants and Early Toddlers; Characteristics, Clinical and Radiological Outcomes Compared with Older Children. J INVEST SURG 2022; 35:1797-1805. [DOI: 10.1080/08941939.2022.2123577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Ahmet Hamdi Akgülle
- Department of Orthopaedic Surgery and Traumatology, Marmara University School of Medicine, Istanbul, Turkey
| | - Yavuz Şahbat
- Department of Orthopaedic Surgery and Traumatology, Marmara University School of Medicine, Istanbul, Turkey
| | - Özgür Baysal
- Department of Orthopaedic Surgery and Traumatology, Marmara University School of Medicine, Istanbul, Turkey
| | - Hayati Kart
- Department of Orthopaedic Surgery and Traumatology, Marmara University School of Medicine, Istanbul, Turkey
| | - Bülent Erol
- Department of Orthopaedic Surgery and Traumatology, Marmara University School of Medicine, Istanbul, Turkey
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