DIAGNOSTIC TACTICS FOR TRANSCONDYLAR AND SUPRACONDYLAR FRACTURES OF THE HUMERUS IN CHILDREN

Trutyak Ihor; Obaranets Oleh

doi:10.31435/rsglobal_ws/30112021/7701

Trutyak Ihor доктор медичних наук, професор, завідувач кафедрою травматології та ортопедії Львівського національного медичного університету ім. Данила Галицького, м. Львів, Україна https://orcid.org/0000-0001-8157-3449
Obaranets Oleh асистент кафедри травматології та ортопедії Львівського національного медичного університету ім. Данила Галицького, м. Львів, Україна https://orcid.org/0000-0002-2463-4345

DOI: https://doi.org/10.31435/rsglobal_ws/30112021/7701

Keywords: Transcondylar and supracondylar fractures of the humerus in children, diagnosis, rotational displacement of fragments

Abstract

Transcondylar and supracondylar fractures of the humerus in children are one of the most relevant and still not completely solved problems of modern pediatric traumatology. In the problem of condylar and supraorbital fractures of the humerus, the issues of diagnosis, choice of indications for surgical revision of the vascular-nervous bundle of the elbow area in this pathology are insufficiently covered. To solve the problems of the study, we analyzed the treatment of 313 victims with transcondylar and supracondylar fractures of the humerus, which were treated at the City Children's Clinical Hospital in Lviv in the period from 2013 to 2018. The structure of the distribution of arrays on the basis of rotational displacement in condylar fractures of the humerus is dominated by displacement up to 30°, which in the first group was found in 61.8% of cases, and in the second group - 69.2% of cases. The share of severe rotational displacements in the structure of group arrays is almost the same in both observation groups: 29.1% in the first group and 29.5% in the second group. Analysis of the proportion of extremely severe rotational displacements up to 90° in the structure of group arrays revealed that such victims were 7 times more among the victims of the first group than among the victims of the second group, due to the use of the proposed unified protocol scheme for diagnosis and treatment humeral fractures in pediatric patients, which avoids or reduces the difference in the occurrence of secondary displacements.

References

Машарипов Ф.А. Лечение чрезмыщелковых переломов плечевой кости у детей с использованием деротационного полукольца. Детская хирургия. 2019. №9 (Т. 23). С. 65-69;

Bell P, Scannell BP, Loeffler BJ, Brighton BK, Gaston RG, Casey V, Peters ME, Frick S, Cannada L, Vanderhave KL. Adolescent Distal Humerus Fractures: ORIF Versus CRPP. J Pediatr Orthop. 2017 Dec;37(8):511-520. http://dx.doi.org/10.1097/BPO.0000000000000715.

Cha S.M., Shin H.D., Ahn J.S., Relationship of cubitus varus and ulnar varus deformity in supracondylar humeral fractures according to the age at injury J Shoulder Elbow Surg (2016) 25, 289–296 http://dx.doi.org/10.1016/j.jse.2015.10.014

Chen TL, He C, Zheng T, Gan Y, Huang M, Zheng Y, et al. Stiffness of various pin configurations for pediatric supracondylar humeral fracture: a systematic review on biomechanical studies. J Pediatr Orthop 2015; 24:389–99, doi: http://dx.doi.org/10.1097/BPB.0000000000000196

Claireaux H, Goodall R, Hill J, Wilson E, Coull P, Green S, Schuster-Bruce J, Lim D, Miles J, Tarassoli P. Multicenter collaborative cohort study of the use of Kirschner wires for the management of supracondylar fractures in children Chin J Traumatol 2019 Oct;22(5):249-254. doi: 10.1016/j.cjtee.2019.06.002.

Mane PP, Challawar NS, Shah H. Late presented case of distal humerus epiphyseal separation in a newborn. BMJ Case Rep. 2016; doi: 10.1136/bcr-2016-215296.

Rupp M, Schäfer C, Heiss C, Alt V. Pinning of supracondylar fractures in children - Strategies to avoid complications Injury. 2019 Jun;50 Suppl 1:S2-S9. doi: 10.1016/j.injury.2019.03.042.

Sahin E, Zehir S, Sipahioglu S. Comparison of medial and posterior surgical approaches in pediatric supracondylar humerus fractures. Niger J Clin Pract. 2017 Sep;20(9):1106-1111. doi: 10.4103/njcp.njcp_104_16.

Sinikumpu JJ, Victorzon S, Pokka T, Lindholm EL, Peljo T, Serlo W. The long-term outcome of childhood supracondylar humeral fractures: A population-based follow up study with a minimum follow up of ten years and normal matched comparisons Bone Joint J 2016 Oct; 98-B(10):1410-1417. doi: 10.1302/0301-620X.98B10.35923.

Tan S. H., Dartnell J., Lim Aks, Huy Jh. Paediatric lateral condyle fractures: a systematic review. Arh. Orthop. Trauma Surg. 2018. Jun, 138; (6):809–817 doi: 10.1007/s00402-018-2920-2.