Simultaneous Ipsilateral Pediatric Fractures of the Elbow and Forearm Attending a Tertiary Care Hospital
Journal Title: Journal of Lumbini Medical College - Year 2016, Vol 4, Issue 1
Abstract
Introduction: Ipsilateral supracondylar humerus and forearm fractures in the pediatric population are an uncommon injury associated with high-energy trauma. The incidence varies between 3% and 13%. Our aim was to conduct a descriptive analysis on seventeen cases of children with floating elbow injuries who attended our institution and to review the literature relating to this topic. Methods: Between April 2013 to March 2016, data were obtained through the medical records. Children who had completely displaced supracondylar fractures of the humerus associated with ipsilateral forearm fracture were reviewed. All patients underwent operative reduction and percutaneous K-wire stabilization. At mean follow up of 12.9 months, all patients were assessed clinically and radiologically. The following variables were used: age, gender, side, mechanism, type of fracture, classification, treatment and complications. Results: Seventeen pediatric "floating elbow" cases that had operative management were identified. Twelve (70.5%%) were male and five (29.4%) female. The mean age was 9.5 (SD=2.1) years, ranging from six to 14 years. The left side was predominantly affected (70.5%). The commonest injury mechanism was fall from a height (76.47%). All the supracondylar fractures were Gartland type III. Majority of forearm fractures (76.4%) were at distal meta diaphyseal region. Distal radius physeal fractures were diagnosed in three patients. Open fractures occurred in three cases (17.6%). All supracondylar fractures were reduced and fixed using K-wires. There was one radial nerve, and three median nerve injury. Five patients had pin tract related complications. Fifteen (88.2%) patients had good to excellent, two had fair in terms of modified Flynn criteria in last month follow up. All patients went on to radiographic union without secondary procedures. Conclusions: This, uncommon injury in most cases, results from high-energy trauma. Early surgical treatment for both fractures is required in the form simultaneous closed reduction of the displaced forearm fracture followed by supracondylar fixation with K-wires. This provides not only stable fixation but also allows close observation for early sign and symptom of development of compartment syndrome.
Authors and Affiliations
Ruban Raj Joshi, Rajeev Dwivedi, Subin Byanjankar, Rahul Shrestha
Keywords
Related Articles
- EP ID EP176220
- DOI 10.22502/jlmc.v4i1.85
- Views 114
- Downloads 0
Coronary Calcium Scoring and Modifiable Coronary Risk Factors
Introduction: Non-invasive coronary calcium scoring predicts earliest atherosclerotic changes in the coronary arteries on the basis of amount of calcium deposited in the coronary arteries. This study was done to analyze...
Risk Factors of Diarrhea in Children Under Five Years in Urban Slums: An Epidemiological Study
Introduction: Diarrhea is a leading cause of mortality in children in developing countries and the condition is worse in slums. In order to provide effective preventive and management strategies, it is important to ident...
Maternal Mortality and Associated Factors in a Tertiary Care Center of Western Nepal
Introduction: Identifying the cause of maternal death is important. The aim of this study was to determine the causes of maternal deaths and the factors associated with it. Methods: This was an observational, cross-sect...
Antibiotic Sensitivity in Post Cesarean Surgical Site Infection at a Tertiary Care Centre in Eastern Nepal
Introduction: Post cesarean surgical site infection (SSI) is one of the common complications diagnosed in 2.5%-16% of the cases and is associated with significant increase in maternal morbidity, hospital stay, costs, and...
Adverse Effects of Oral Hypoglycemic Agents and Adherence to them among Patients with Type 2 Diabetes Mellitus in Nepal
Introduction: Oral hypoglycemic agents (OHAs) are the most common drugs used in Type 2 Diabetes Mellitus. There are various established adverse effects related to their use including hypoglycemia, weight gain, gastrointe...