Proximal humerus fractures are a common fragility fracture that significantly affects the independence of older adults. Management of displaced extensiontype supracondylar. Gartlands classification of supracondylar fracture of humerus. The most frequent fracture pattern at the elbow in children is the supracondylar humerus fracture with an incidence of around 316. For the more severe injuries, traction usually provides the best opportunity to observe. Biomechanical behavior of three types of fixation in the two. Surgical treatment of supracondylar humerus fractures in. A medline and embase databases search was performed to identify articles that focused on the functional, cosmetic, and radiological outcomes, as well as postsurgical complications, regarding different surgical approaches used for open reduction and pinning in severely displaced supracondylar humerus fractures in children. Management of complex proximal humerus fractures in the. Gartlands classification of supracondylar fracture of. This is called a supracondylar supra con dy ler humerus fracture.
Fractures of the proximal humerus are common and most often treated nonoperatively. Supracondylar fractures of the humerus in children youtube. A humerus fracture is a break of the humerus bone in the upper arm. The treatment of humeral fractures is a complex issue and the source of. Surgical approaches for open reduction and pinning in. Skaggs dl, sankar wn, albrektson j, vaishnav s, choi pd, kay rm. Endoscopic excision of supracondylar humeral spur for. After fracture stabilization, the humeral shafts were embedded in a 2part epoxy resin bondomarhyde, atlanta, ga and secured with custom. Gartlands classification of supracondylar fracture of humerus galeazzi fracture a fracture of the radius with dislocation of the distal radioulnar joint colles fracture a distal fracture of the radius with dorsal posterior displacement of the wrist and hand smiths fracture a distal fracture of the. This summary does not contain rationales that explain how and why these recommendations were developed nor does it contain the evidence supporting these recommendations. The large number of articles, extensive body of literature and numerous treatment proposals reflect the importance of this fracture 14.
Arterial damage accompanying supracondylar fractures of. Supracondylar fractures are a very common type of broken elbow seen in kids, especially ages 38 years old. Pdf paediatric supracondylar fractures of the humerus. The supracondylar fracture of the humerus is the mostcommon and the likely, when badly displaced, to be accompanied by vascular injury. The humeral supracondylar process and struthers ligament comprise a relatively rare but wellknown anatomic variant. The ultimate goal of management of proximal humeral fractures in the elderly patient is to get the patient.
Any information contained in this pdf file is automatically generated from. It is also the commonest pediatric fracture around the elbow. Supracondylar fractures of the humerus sch are the most common fractures about the elbow in children that require operative stabilization. These fractures are the result of trauma to the elbow, most often from a fall from height monkey bars are. They are usually asymptomatic but may produce clinical symptoms related to compression of the median nerve or brachial artery below the ligament. The humerus hu mer us bone is the long, thick bone in the upper arm that extends from the shoulder to the elbow.
Fractures of the proximal humerus are common and most often treated non operatively. An injury around the elbow where fracture line runs just above the coronoid and radial fossa transversely sparing the epicondyles. Backgroundthe aim of this study was to examine the effect of arm. These fractures require open reduction and pin fixation. The association with neurovascular compromise and the potential problems of accurately reducing a displaced fracture can make treatment difficult particularly for the unwary surgeon. Pdf on jan 1, 2011, breck lord and others published paediatric supracondylar fractures of. How safe is the operative treatment of gartland type 2 supracondylar humerus fractures in children. Supracondylar humeral fractures are a common paediatric elbow injury, but are almost never seen in adults the peak age of incidence is between 57 years. Kids broken elbow supracondylar fracture bone talks. Supracondylar humerus fractures shf comprise 17% of all pediatric fractures and are second in frequency to forearm fractures. Your childs humerus is fractured broken near the elbow area, just above the joint. Simple supracondylar fractures are typically seen in younger children, and are uncommon in adults.
Describe necessary components of the physical exam of a child with a displaced supracondylar fracture 4. Fracture of the proximal humerus is a common orthopaedic injury and is. Open reduction and internal fixation for displaced. Supracondylar humerus fractures and brachial artery injuries. Comparative study of cross and lateral fixations on supracondylar humerus fracture among children. Supracondylar fracture of the humerus is the second most common fracture in children 16. We prospectively followed 52 children who presented with gartland type 3 displaced supracondylar fractures of the humerus and were managed by open reduction and internal fixation with crossed kwires via lateral approach. Supracondylar humerus fractures is one of the commonest fractures in pediatric elbow. Pediatric supracondylar fractures are one of the most common traumatic fractures see in children and most commonly occur in children 57 years of age, usually from a fall on an outstretched hand.
Supracondylar fractures of the humerus in children. Usually closed reduction and percutaneous pinning is the preferred treatment for most of the displaced fractures. Treatment is usually closed reduction and percutanous pinning crpp, with the urgency depending on whether the hand remains perfused or not. Documentation of neurovascular status in supracondylar. All books are in clear copy here, and all files are secure so dont worry about it. Supracondylar humerus fracture what is a supracondylar fracture. Biomechanical analysis of pin placement for pediatric. A joint effusion raises the anterior and posterior fat pads, indicating intracapsular injury. According to an epidemiological study, the incidence of fracture supracondylar humerus is 30800 per year in the general population. Open reductions of paediatric supracondylar humerus. This was the first childrens hospital admission for this 9 12yearold white female. These fractures are more commonly seen in boys 4 these injuries are almost always due to accidental trauma, such as falling from a moderate height bedmonkeybars 4. Flexion supracondylar humeral fractures account for only 24% of all supracondylar fractures 1. The aim of this study was to determine the prevalence and outcome of supracondylar fractures.
Read online gartlands classification of supracondylar fracture of humerus book pdf free download link book now. Comparative study of cross and lateral fixations on. A supracondylar fractures of the elbow in children, part 1 and 2. These fractures are classified using the modified gartland. Supracondylar fractures of the distal humerus are a commonly encountered injury in children. Open supracondylar fracture of the humerus jama jama. The specific etiology of supracondylar humerus fractures in children is not well known. Unlike the much more common extension supracondylar fracture which are seen in children, flexion fractures are seen in older patients.
Arterial damage is sometimes associated with supracondylar fractures of the humerus. Previously, surgery has been performed with an open ligament release and supracondylar process excision. They occur after a fall onto an outstretched arm, and they usually by falling off the monkeybars. Pdf download for the biomechanics of proximal humeral fractures. The patient had fallen from a horse, striking the left elbow, approximately one hour before admission. Simple and complex fractures of the humerus a guide to. The distal fracture fragment is pulled posteriorly by the. The presence of a narrow anterior fat pad aka sail sign can be normal.
The fracture is usually transverse or oblique and above the medial and lateral condyles and epicondyles. Supracondylar humerus fractures pediatric orthopaedic. Flexion supracondylar fracture radiology reference. Application of contoured plates in buttress fashion no. Anatomic articular reduction and provisional fixation as much as possible 2. For only a few more days, your donation will be matched 2to1. Describe useful radiographic parameters for assessing quality of reduction of supracondylar fractures 3. Supracondylar humerus fracture nationwide childrens. She had been taken to a neighboring hospital where a sterile dressing had been applied to the open wound at the elbow, and the extremity had been splinted with an inflatable splint. Pdf supracondylar fractures of the humerus in children.
Traumatic shoulder injuries include fractures of the proximal humerus, dislocations. A supracondylar humerus fracture is a fracture of the distal humerus just above the elbow joint. Supracondylar fractures are the most common fracture of the elbow in children. Distal humerus fractures orthopaedic trauma association. Functional and quality of life outcome after nonoperatively. We use your linkedin profile and activity data to personalize ads and to show you more relevant ads.
Supracondylar fractures constitutes approximately 50% of all fractures. The annual rate of children who present with supracondylar fractures. Outerbridgekashiwagi procedure for the treatment of a. Supracondylar fracture directory of open access journals. All readers of this summary are strongly urged to consult the full guideline and evidence. The backslab and sling should be placed under figure 2. Less than one third of the capitulum of the humerus lies in front of the anterior humeral line. This fracture pattern is relatively rare in adults, but is the most common type of elbow fracture in children. Nowadays closed reduction and percutaneous pinning has become standard of care for majority of displaced supracondylar humerus fractures. Supracondylar fracture teachmesurgeryteachmesurgery. Supracondylar fractures of the humerus in children are the result of trauma to the elbow, most often a fall from height or related to sports or leisure activities. True anteroposterior and lateral radiographs are essential not only for an accurate diagnosis, but also for creating a treatment plan for these injuries. Supracondylar humerus fractures are the most common elbow fracture in children and most often occur between 5 and 7 years of age on the nondominant elbow.
Raise the arm on a pillow when sitting or lying down loose fitting clothing, not through the sleeve. Provisional internal fixation of articular surface to shaft 3. Biomechanical analysis of pin placement for pediatric supracondylar humerus fractures. Supracondylar humeral fracture radiology reference. Fracture supracondylar humerus some important facts. Supracondylar fractures of the humerus springerlink. To the internet archive community, time is running out. This is the most common upper extremity fracture pattern in younger children, and the vascularinjury rate is. Supracondylar fractures of the humerus are a common pediatric elbow injury that are historically associated with morbidity due to malunion, neurovascular complications, and compartment syndrome. Ebraheims educational animated video describing supracondylar fractures of the distal humerus in children. Describe a useful classification system for supracondylar fractures of the humerus 2. The perfused, pulseless supracondylar humeral fracture. This is the most common upper extremity fracture pattern in younger children, and the vascularinjury rate is as high as 10%. Deformity following supracondylar fractures of the humerus.
Download acrobat pdf file 571kb icmje author disclosure forms. A particular subset of pediatric extremity vascular injuries is the pink pulseless hands associated with supracondylar humerus fractures. All supracondylar humerus fractures treated at childrens hospital and health center, san diego chsd over. The results of treatment by four different methods were assessed clinically and compared. They are usually the result of a fall directly onto a flexed elbow. Pdf outline of fractures ebooks download open reduction and lag screw fixation through a radial approach is the treatment of choice for long oblique proximal phalanx fractures pdf outline of fractures. Diagnosis and careful management of the fracture and arterial repair is crucial. Adams outline of fractures pdf free download ebook download. Supracondylar fracture pediatric pediatrics orthobullets. Download gartlands classification of supracondylar fracture of humerus book pdf free download link or read online here in pdf. Considering the possible complications involved including nerve deficit and compartment syndrome, documentation is crucial to good patient care. Hemiarthroplasty, plate fixation, proximal humeral fracture, reverse arthroplasty, shoulder fracture view abstract download pdf.
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