scholarly journals Conservative Follow-up of Severely Displaced Distal Radial Metaphyseal Fractures in Children

Cureus ◽  
2018 ◽  
Author(s):  
Deniz Akar ◽  
Cenk Köroğlu ◽  
Serkan Erkus ◽  
Ali Turgut ◽  
Önder Kalenderer
Keyword(s):  
Fractures In Children ◽  
Metaphyseal Fractures

scholarly journals Treatment of Distal Forearm Fractures in Children

2020 ◽  
pp. 145749692098310
Author(s):  
J.-J. Sinikumpu ◽  
Y. Nietosvaara
Keyword(s):  
Case Series ◽  
Distal Forearm ◽  
Articular Fractures ◽  
Fractures In Children ◽  
K Wires ◽  
Metaphyseal Fractures ◽  
Distal Forearm Fractures ◽  
Anatomic Alignment ◽  
Physeal Fractures

Background and Aims: Distal forearm is the most common fracture location in the growing skeleton. The aim of this article is to describe the current practice of these fractures. Materials and Methods: Case series accompanied by experts’ opinion. Results and Conclusion: Most of these injuries are benign incomplete distal metaphyseal torus fractures best treated with a dorsal below elbow splint for 2–3 weeks with no follow-up. Completely displaced metaphyseal fractures in prepubertal children can be either immobilized in bayonet position after axial alignment or fixed with K-wires after reduction. Complete fractures of distal metaphysis in adolescents should heal in near anatomic alignment because remodeling is uncertain. We advocate reduction of most greenstick and complete fractures at the distal metaphyseal diaphyseal junction and radiographic follow-up to monitor fracture alignment. Physeal fractures in adolescents and intra-articular fractures in children of all ages should be anatomically reduced. We perform most of our osteosyntheses with K-wires.

scholarly journals Randomized Controlled Trial of the Clinical Recovery and Biodegradation of Polylactide-co-glycolide Implants Used in the Intramedullary Nailing of Children’s Forearm Shaft Fractures with at Least Four Years of Follow-Up

2021 ◽  
Vol 10 (5) ◽  
pp. 995
Author(s):  
Marja Perhomaa ◽  
Tytti Pokka ◽  
Linda Korhonen ◽  
Antti Kyrö ◽  
Jaakko Niinimäki ◽  
...  
Keyword(s):  
Intramedullary Nailing ◽  
Controlled Trial ◽  
Long Term Outcomes ◽  
Intramedullary Nails ◽  
Metal Implants ◽  
Shaft Fractures ◽  
Fractures In Children ◽  
Significant Difference

The preferred surgical fixation of forearm shaft fractures in children is Elastic Stable Intramedullary Nailing (ESIN). Due to known disadvantageous effects of metal implants, a new surgical method using biodegradable polylactide-co-glycolide (PLGA) intramedullary nails has been developed but its long-term outcomes are unclear. The aim of this study was to compare the long-term outcomes of Biodegradable Intramedullary Nailing (BIN) to ESIN and assess the biodegradation of the study implants via magnetic resonance imaging (MRI). The study population of the prospective, randomized trial consisted of paediatric patients whose forearm shaft fractures were treated with BIN (n = 19) or ESIN (n = 16). Forearm rotation at minimally four years’ follow-up was the main outcome. There was no clinically significant difference in the recovery of the patients treated with the BIN as compared to those treated with the ESIN. More than half of the implants (57.7%, n = 15/26) were completely degraded, and the rest were degraded almost completely. The PLGA intramedullary nails used in the treatment of forearm shaft fractures in this study resulted in good function and anatomy. No unexpected disadvantages were found in the degradation of the implants. However, two implant failures had occurred in three months postoperatively.

scholarly journals Plate Fixation for Irreducible Proximal Humeral Fractures in Children and Adolescents—A Single-Center Case Series of Six Patients

Children ◽  
2021 ◽  
Vol 8 (8) ◽  
pp. 635
Author(s):  
Florian Freislederer ◽  
Susanne Bensler ◽  
Thomas Specht ◽  
Olaf Magerkurth ◽  
Karim Eid
Keyword(s):  
Closed Reduction ◽  
Biceps Tendon ◽  
Plate Fixation ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Constant Murley Score ◽  
Fractures In Children ◽  
Initial Surgery ◽  
Conjoint Tendon

Background: Recommended treatment for severely displaced proximal humeral fractures in children is the closed reduction and percutaneous fixation by K-wires or intramedullary nailing. Methods: From January 2016 to January 2017 6, 21 children/adolescents (range 8 to 16 years) with proximal humeral fractures were treated surgically for severe displacement. In these six patients, several attempts of closed reduction were unsuccessful, and an open reduction was performed. The humeral head was fixed with a 3.5 mm T-plate without affecting the growth plate. Plate removal was performed at a mean interval of 132 days after initial surgery. Two years after initial surgery, the clinical outcome was assessed by the Constant–Murley score and QuickDASH score (including sport/music and work) and the shoulder joint was evaluated with a standardized sonographic examination for the rotator cuff and the conjoint tendon. Results: In all six patients, dorsal displacement of the fracture was irreducible due to the interposition of tendinous or osseous structures. Intraoperatively, the interposed structures were the long biceps tendon in two, periosteal tissue in two, a bony fragment in one, and the long biceps tendon together with the conjoint tendon in one case. At mean follow-up of 26 months (range 22 months to 29 months), patients showed very good clinical results with an excellent mean Constant–Murley score of 97.5 (range 91 to 100) and mean QuickDASH score (including sport/music and work) of 5.5 (range 0–20.8). An X-ray follow-up 6 weeks after surgery demonstrated early consolidation and correct alignment in all patients. A sonographic evaluation at 2 years post injury showed that the biceps and the conjoined tendon were intact in all patients. Conclusions: If a proximal humeral fracture is not reducible by closed means, a tissue entrapment (most likely biceps tendon) should be considered. Treatment with an open reduction and plate fixation yields very good clinical and radiological results and preserves interposed structures as the biceps and conjoint tendon.

scholarly journals Minimally angulated pediatric wrist fractures: Is immobilization without manipulation enough?

CJEM ◽  
2007 ◽  
Vol 9 (01) ◽  
pp. 9-15 ◽  
Author(s):  
Khalid Al-Ansari ◽  
Andrew Howard ◽  
Brian Seeto ◽  
Solina Yoo ◽  
Salma Zaki ◽  
...  
Keyword(s):  
Distal Radius ◽  
Sagittal Plane ◽  
Normal Function ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Post Injury ◽  
Radiographic Findings ◽  
Fractures In Children ◽  
Plaster Immobilization

ABSTRACT Background: Emergency department (ED) manipulation of complete minimally angulated distal radius fractures in children may not be necessary, due to the excellent remodeling potential of these fractures. Objectives: The primary objective of this study was to determine the proportion of minimally angulated distal radius fractures managed in the ED with plaster immobilization that subsequently required manipulation. Our secondary objective was to document, at follow-up, changes in angulation for each wrist fracture. Methods: This retrospective cohort study reviewed consecutive records of all children with bi-cortical minimally angulated (≤15° of angulation in the sagittal plane and ≤0.5 cm of displacement) distal metaphyseal radius fractures, alone or in combination with distal ulnar fracture. Details of treatment, radiographic findings, and clinical outcomes during the subsequent orthopedic follow up were recorded. Results: Of 124 patients included in the analysis, none required manipulation after their ED visit. All but 14 (11.3%) fractures were angulated ≤20° within the follow-up period. Two (1.6%) fractures that were initially angulated ≤15° progressed to 30°–35°, but remodeled within 2 years to nearly perfect anatomic alignment. By 6 weeks post-injury, no patients had clinically apparent deformity and all had normal function. Conclusions: Minimally angulated fractures of the distal metaphyseal radius managed in plaster immobilization without reduction in the ED are unlikely to require future surgical intervention.

scholarly journals The Influence of Assisted Fixation on Pain Relief for Subtrochanteric Femur Fractures in Children

2020 ◽  
Author(s):  
Jin Li ◽  
Wenqi Liu ◽  
Yiyuan Chen ◽  
Yan Zhou ◽  
Jiaxin Liang ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Level ◽  
Spica Casting ◽  
Femur Fractures ◽  
Fractures In Children ◽  
Vas Scores ◽  
Subtrochanteric Femur Fractures ◽  
Skin Traction ◽  
Postoperative Pain Level

Abstract Background : Subtrochanteric femur fractures of children usually recover slower than the intertrochanteric femur fracture and tends to increas the rate of deformity. The difference among treatment options in postoperative pain level should be considered as a crucial factor while tailoring patients’ therapeutic schedules, but has not been paid enough attention to. This study aimed to evaluate and compare the postoperative pain level of hip spica casting, abduction brace and skin traction as assisted fixation to operative interventions. Methods Forty-seven children with subtrochanteric femur fractures on one side were admitted and divided into three groups according to the different assisted fixation they received. Operating time, intraoperative blood loss, follow-up time, postoperative fixation time, days in hospital, time to union, Harris scores, CHEOPS scores (before treatment, after treatment and at the last follow-up time) and VAS scores (before treatment, after treatment and at the last follow-up time) were collected. Results No significant difference of demographic characteristics data was found between the three groups before treatment(P > 0.05). After treatment and at the last follow-up time, the CHEOPS scores and the VAS scores of the three groups were all significantly lower than before(P > 0.05). But there is still no difference between the three groups(P > 0.05). Conclusion Hip spica casting, skin traction and abduction brace have the same ability to relieve the pain of subtrochanteric femur fractures in children.

scholarly journals Conservative Approach to Unilateral Condylar Fracture in a Growing Patient: A 2.5-Year Follow Up

2012 ◽  
Vol 6 (1) ◽  
pp. 1-4 ◽  
Author(s):  
Elif Bahar Tuna ◽  
Aysun Dündar ◽  
Abdülkadir Burak Çankaya ◽  
Koray Gençay
Keyword(s):  
Conservative Treatment ◽  
Mouth Opening ◽  
Facial Asymmetry ◽  
Mandibular Growth ◽  
Fractures In Children ◽  
Facial Swelling ◽  
Direct Pressure ◽  
Condylar Head ◽  
Condylar Fractures

Condylar fractures in children are especially important because of the risk of a mandibular growth-center being affected in the condylar head, which can lead to growth retardation and facial asymmetry. The purpose of this article is to follow up the two and half year clinical and radiological evaluation of the conservative treatment of a 10 year-old patient, who had a unilateral green-stick type fracture. The patient presented with painful facial swelling localized over the left condylar region, limited mouth-opening and mandibular deviation to the left. Panoramic radiography and computed tomography confirmed the diagnosis of incomplete fracture on the left condyle with one side of the bone fractured and the other bent. Closed reduction was chosen to allow for initial fibrous union of the fracture segments and remodeling with a normal functional stimulus. A non-rigid mandibular splint was applied in order to remove the direct pressure on the fracture side of the mandible. Clinical and radiologic examination after 30 months revealed uneventful healing with reduction of the condylar head and remodeling of the condylar process following conservative treatment.

scholarly journals Pseudoarthrosis of second metatarsal fracture

2018 ◽  
Vol 40 (2) ◽  
Author(s):  
Jessica Zanovello ◽  
Barbara Bertani ◽  
Redento Mora ◽  
Gabriella Tuvo ◽  
Mario Mosconi ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Good Clinical Outcome ◽  
Non Union ◽  
Fractures In Children ◽  
Second Metatarsal ◽  
Traumatic Fracture ◽  
Metatarsal Fracture ◽  
Metatarsal Fractures ◽  
Foot Fractures

Metatarsal fractures make up the greatest portion of foot fractures in children. Most of them are treated with closed reduction and non-weightbearing cast immobilization.Usually, these fractures heal uneventfully and delay union and pseudoarthrosis are rare. We report a case of a 10-year-old child with non-union of the second metatarsal following a traumatic fracture, caused by an accident 10 months before, and treated successfully by osteosynthesis with plate and screws. Good clinical outcome was achieved at 2 years follow-up.

The Utility of the Early Postoperative Follow-up and Radiographs After Operative Treatment of Supracondylar Humerus Fractures in Children

2020 ◽  
Vol 40 (5) ◽  
pp. 218-222
Author(s):  
Anna M. Acosta ◽  
Yi-Ju Li ◽  
Viviana Bompadre ◽  
Alex Mortimer ◽  
Michael Trask ◽  
...  
Keyword(s):  
Operative Treatment ◽  
Fractures In Children ◽  
Supracondylar Humerus Fractures ◽  
Humerus Fractures

Neurogenic claudication associated with posterior vertebral rim fractures in children

2012 ◽  
Vol 10 (3) ◽  
pp. 241-245 ◽  
Author(s):  
Jonathan G. Thomas ◽  
Jerome Boatey ◽  
Alison Brayton ◽  
Andrew Jea
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Signs And Symptoms ◽  
Leg Pain ◽  
Neurogenic Claudication ◽  
Pediatric Age Group ◽  
Fractures In Children ◽  
The Mean

Object Outside of the patient population with achondroplasia, neurogenic claudication is rare in the pediatric age group. Neurogenic claudication associated with posterior vertebral rim fracture is even more uncommon but nonetheless causes pain and disability in affected children and adolescents. The purpose of this study was to describe the surgical results of 3 adolescents presenting with neurogenic claudication and posterior vertebral rim fracture when treated with laminectomy alone. Methods The medical and operative records of the 3 pediatric patients were retrospectively reviewed. Presenting signs and symptoms and CT findings, such as the interpedicular distances between T-12 and L-5, were obtained. Perioperative results were assessed, including operative time, blood loss, length of hospital stay, and complications. Findings at latest follow-up were also recorded, including a patient satisfaction survey. Results The 3 patients (1 girl and 2 boys) had a mean age of 14.7 years (range 14–15 years) and underwent follow-up for a mean of 11.3 months (range 5–18 months). Notable preoperative signs and symptoms included back pain (all patients), leg pain (all patients), leg numbness (1 patient), and leg weakness (1 patient). No patient presented with bowel and/or bladder dysfunction. The mean blood loss during laminectomy was 123 ml (range 20–300 ml), and the mean length of hospital stay was 4.3 days (range 3–6 days). On average, decompression was performed at 2.2 levels (range 2–2.5 levels). All 3 patients reported at most recent follow-up that they were “satisfied” with the surgery. There was 1 complication of instability from an iatrogenic pars fracture, which required reoperation and posterior instrumented fusion. Conclusions To the best of the authors' knowledge, this report represents the first surgical series of pediatric neurogenic claudication associated with posterior vertebral rim fractures. Pediatric neurosurgeons may infrequently encounter neurogenic claudication associated with a posterior vertebral rim fracture in children. To treat children with neurogenic claudication associated with posterior vertebral rim fractures, a simple laminectomy may be a safe and efficacious alternative to discectomy and removal of fracture fragments.

Atlantal fracture with transverse ligament disruption in a child

2009 ◽  
Vol 4 (3) ◽  
pp. 196-198 ◽  
Author(s):  
Marcelo D. Vilela ◽  
Eric C. Peterson
Keyword(s):  
Cervical Spine ◽  
Surgical Treatment ◽  
Upper Cervical Spine ◽  
Transverse Ligament ◽  
Jefferson Fracture ◽  
Fractures In Children ◽  
Upper Cervical ◽  
Almost All ◽  
Ligament Disruption

Even though fractures in children with immature spines occur predominantly in the upper cervical spine, isolated C-1 fractures are relatively rare. The fractures in almost all cases reported to date were considered stable due to the presence of the intact transverse ligament. The authors report the case of a young child who sustained a Jefferson fracture and in whom MR imaging revealed disruption of the transverse ligament. Although surgical treatment has been suggested as the treatment of choice for children with unstable atlantoaxial injuries, external immobilization alone allowed a full recovery in the patient with no evidence of instability at follow-up.

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