Transverse Anterior Approach to the Elbow for Pediatric Displaced Lateral Humeral Condyle Fractures | ||
The Archives of Bone and Joint Surgery | ||
مقاله 3، دوره 8، شماره 2، خرداد 2020، صفحه 142-146 اصل مقاله (1.05 M) | ||
نوع مقاله: RESEARCH PAPER | ||
شناسه دیجیتال (DOI): 10.22038/abjs.2019.30756.1797 | ||
نویسندگان | ||
Francisco Soldado F.* 1؛ Pedro Domenech-Fernandez1؛ Sergi Barrera-Ochoa2؛ Josep M. Bergua-Domingo1؛ Paula Diaz-gallardo1؛ Felipe Hodgson3؛ Jorge Knorr1 | ||
1Pediatric Hand Surgery and Microsurgery, UCA Unit, Vithas San Jose, Barcelona, Spain | ||
2ICATMA Hand and Microsurgery Unit; ICATME, Hospital Universitari Quiron-Dexeus, Barcelona, Spain | ||
3Department of Orthopaedic Surgery, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile | ||
چکیده | ||
Background: The anterior approach to the elbow for pediatric lateral condyle fractures (LCF) would provide a better visualization of the articular fracture resulting in better functional results, less complications and a more cosmeticallyappealing scar than usually seen with the lateral approach. Methods: Retrospective study of children undergoing an open reduction and internal fixation of a displaced LCF via an anterior approach with a transverse incision. Bilateral elbow range of motion (ROM), upper limb alignment and complications were registered. A 4-point ordinal Likert-type scale was employed for parents to rate their level of satisfaction with the cosmetic appearance of the scar. Results: Eighteen children of mean age 76 months (range 27 to 101 months) were included. Fractures were classified as Jackob’s Type II in 14 cases and Milch’s type II in all cases. Mean follow-up was 12 (range 4 to19) months. Successful condral fracture visualization and reduction was achieved in every case. No intra-operative or post-operative complications occurred. In all cases bone union was obtained 4 to 5 weeks after surgery and at final follow-up, active elbow ROM of at least 90%, was obtained. All parents claimed to be “very satisfied” with their child’s scar. A lateral spur was identified in 66.7% o patients. Conclusion: The anterior approach to the elbow was both a feasible and safe allowing full anatomical cartilage reduction. Complications after this technique might decrease compared to the lateral approach but need future comparative studies. The rate of lateral spur did not decreased. Cosmetic scar results seem to be a clear advantage of this approach compared to the classical lateral approach. Level of evidence: IV | ||
کلیدواژهها | ||
Elbow anterior approach؛ Lateral humeral condyle fracture؛ Pediatric elbow | ||
مراجع | ||
1. Beaty JH. Fractures of the lateral humeral condyle are the second most frequent elbow fracture in children. J Orthop Trauma. 2010; 24(7):438. 2. Silva M, Cooper SD. Closed reduction and percutaneous pinning of displaced pediatric lateral condyle fractures of the humerus: a cohort study. J Pediatr Orthop. 2015; 35(7):661-5. 3. Mintzer CM, Waters PM, Brown DJ, Kasser JR. Percutaneous pinning in the treatment of displaced lateral condyle fractures. J Pediatr Orthop. 1994; 14(4):462-5. 4. Song KS, Shin YW, Oh CW, Bae KC, Cho CH. Closed reduction and internal fixation of completely displaced and rotated lateral condyle fractures of the humerus in children. J Orthop Trauma. 2010; 24(7):434-8. 5. Jakob R, Fowles JV, Rang M, Kassab MT. Observations concerning fractures of the lateral humeral condyle in children. J Bone Joint Surg Br. 1975; 57(4):430-6. 6. Milch H. Fractures and fracture dislocations of the humeral condyles. J Trauma. 1964; 4(1):592-607. 7. Imatani J, Morito Y, Hashizume H, Inoue H. Internal fixation for coronal shear fracture of the distal end of the humerus by the anterolateral approach. J Shoulder Elbow Surg. 2001; 10(6):554-6. 8. Hausman MR, Qureshi S, Goldstein R, Langford J, Klug RA, Radomisli TE, et al. Arthroscopically-assisted treatment of pediatric lateral humeral condyle fractures. J Pediatr Orthop. 2007; 27(7):739-42. 9. Song KS, Waters PM. Lateral condylar humerus fractures: which ones should we fix? J Pediatr Orthop. 2012; 32(Suppl 1):S5-9. 10. Bauer AS, Bae DS, Brustowicz KA, Waters PM. Intra-articular corrective osteotomy of humeral lateral condyle malunions in children: early clinical and radiographic results. J Pediatr Orthop. 2013; 33(1):20-5. 11. Weiss JM, Graves S, Yang S, Mendelsohn E, Kay RM, Skaggs DL. A new classification system predictive of complications in surgically treated pediatric humeral lateral condyle fractures. J Pediatr Orthop. 2009; 29(6):602-5. 12. Haraldsson S. On osteochondrosis deformans juvenilis capituli humeri including investigation of intra-osseous vasculature in distal humerus. Acta Orthop Scand. 1959; 30(sup38):5-232. 13. Pribaz JR, Bernthal NM, Wong TC, Silva M. Lateral spurring (overgrowth) after pediatric lateral condyle fractures. J Pediatr Orthop. 2012; 32(5):456-60. 14. Ersan O, Gonen E, İlhan RD, Boysan E, Ates Y. Comparison of anterior and lateral approaches in the treatment of extension-type supracondylar humerus fractures in children. J Pediatr Orthop B. 2012; 21(2):121-6. 15. Thomas DP, Howard AW, Cole WG, Hedden DM Three weeks of Kirschner wire fixation for displaced lateral condylar fractures of the humerus in children. J Pediatr Orthop. 2001; 21(5):565-9. | ||
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