The Relationship between the Dominant Hand and the Occurrence of the Supracondylar Humerus Fracture in Pediatric Orthopedics (original) (raw)
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Hand dominance and gender in forearm fractures in children
Strategies in Trauma and Limb Reconstruction, 2008
No published studies have addressed the role of hand dominance in various types of forearm fractures. The present study aims to investigate the effects of the dominant hand and gender in forearm fractures in children and adolescents. In a prospective study, 181 children aged 2-15 years presenting with unilateral forearm fracture were examined over a 6-year period, investigating the role of the dominant hand, fractured side, fractured site, and gender in different types of forearm fractures. Forearm fractures occur more often in boys and are more common on the left side (P = 0.001, 0.029, respectively). Isolated distal radius fracture is more common than distal radius and ulna fracture in right-handed children (P = 0.008). Increases in the number of middle forearm fractures in the dominant hand in left-handed children (P = 0.0056) may be due to mechanisms of injury other than a simple indirect fall or severe injury preventing the use of the dominant hand as a preventive measure. The mean age for boys and girls at the time of forearm fractures was 8.97 and 5.98 years, respectively, which may be attributed to older girls tending not to do as many outside-the-home activities as boys at this age. Overall, forearm fractures are more common in the non-dominant hand, in boys, and in both distal forearm bones.
UNSTRUCTURED Outdoor play and risk-taking behaviours, including play at heights, are important to children’s physical, social and cognitive development (14–18). These aspects of play are important to consider when informing prevention policies for serious injuries that commonly occur on play structures. Supracondylar fractures of the humerus (SCH) are the most common type of elbow fractures that result from falls on an outstretched hand among healthy children (1,2). Despite being one of the leading causes of admission to hospital and surgical intervention (6–9), the details surrounding the cause of these injuries are often not recorded. Previous research has correlated decreased overall playground safety with higher rates of SCH fractures (11). Play structure height, as well as the type of undersurface have been identified as potential risk factors for severe injuries, including SCH fractures, in part due to their low compliance with safety standards (10,12). To inform evidence-base...
Temporal variation in pediatric supracondylar humerus fractures requiring surgical intervention
Journal of Children's Orthopaedics, 2012
Background Pediatric supracondylar humerus fractures commonly require surgical intervention and hospital admission, which is costly and consumes significant health care resources. There are few data regarding temporal characteristics (month, day and hour of injury) of this particular pediatric fracture. We wished to investigate the month, day of the week, and time of occurrence of these fractures to guide appropriate use of health care resources and prevention strategies. Methods This study was a retrospective review of clinical records and radiographs of 353 children with operative supracondylar humerus fractures in a temperate climate region over 6 years. Date and time of injury and demographic data (gender, age, laterality) were extracted. Variation in month, weekday, and time of injury was analyzed using circular analysis, cosinor analysis, probability distributions and topographical distribution. Results There was a statistically significant increase in the number of fractures ...
Patterns of Pediatric Supracondylar Humerus Fractures
Journal of Pediatric Orthopaedics, 2008
Purpose: The Wilkins-modified Gartland classification of pediatric supracondylar humerus fractures does not consider coronal or sagittal obliquity. The purposes of our study were (1) to identify and describe fracture characteristics with unique properties and (2) to propose a fracture classification system that can be reproduced reliably. Methods: We retrospectively studied 203 consecutive displaced pediatric extension-type supracondylar humerus fractures treated operatively from January 1998 to January 2003. Fracture characteristics (eg, coronal and sagittal obliquity, postoperative alignment), type of surgical treatment, outcome, and complications were assessed and analyzed statistically with Student t test and a receiver operating characteristic curve. Significance was defined as P G 0.05. We incorporated significant cutoff values for fracture obliquity into our classification scheme and tested the classification's interobserver and intraobserver reliability. Results: We identified 4 coronal (typical transverse, medial oblique, lateral oblique, and high fractures) and 2 sagittal (low sagittal and high sagittal) subtypes with significantly different characteristics and outcome. Compared with fractures with coronal obliquity of less than 10 degrees, fractures with coronal obliquity of 10 degrees or greater were associated with significantly more comminution and rotational malunion. Compared with fractures with sagittal obliquity of less than 20 degrees, fractures with sagittal obliquity of 20 degrees or greater were associated with a significantly higher incidence of additional injuries and were more likely to result in extension malunion. Analysis of the interobserver and intraobserver reliability for our system identified correlation coefficients ranging from 0.772 to 0.907 and 0.860 to 0.899, respectively. Conclusions: Because pediatric extension-type supracondylar humerus fractures vary significantly in terms of characteristics, identification of sagittal oblique and coronal oblique angles may have an important role in surgical decision making and may impact outcomes. Level of Evidence: Level 3 (retrospective study).
Journal of Nepal Medical Association, 2021
Introduction: Supracondylar fractures of humerus are the most common elbow fractures in children consisting of about 15% of all pediatric fractures and more than half of all elbow fractures. A high incidence of nerve injures, and vascular injuries make this fracture a serious injury. Our study aims to study on the clinical and demographic pattern of pediatric supracondylar fracture cases presenting in the hospital retrospectively.Methods: We conducted a descriptive cross-sectional study in Seti Provincial Hospital in the month of December. The data from the medical record section was retrospectively collected. A whole sampling technique was used. The descriptive statistical analysis was done.Results: Seven hundred cases were studied, among which the most common age group was found to be 5-10 410 (58.57%). Most of the cases presented in the emergency department 513 (73.28%), and the most common time of presentation was from 3 AM to 6 AM 170 (24.28%).Conclusions: Supracondylar fractur...
Correlation Between Bauman's and Carrying Angle in Children with Supracondylar Fracture of Humerus
Medical Archives, 2013
S upracondylar fractures are the result of a fall on outstretched hand in more than 70% of cases, and more common in the non-dominant arm. Bauman' s angle is used to determine the degree of displacement and angulation, and the quality of fracture reduction. Carrying angle is the clinical parameter of varus-valgus angulation with elbow fully extended and forearm completely supinated. Patients and methods: The study was a retrospective-prospective and there were analyzed children under 14 years of age with supracondylar humerus fracture. They were analyzed by X-ray anteroposterior view of injured elbow, made before and after the surgery, with measuring Bauman' s angle. Clinical examination was performed after completing physical therapy, when was measured carrying angle of the injured and healthy elbow using a goniometer. Results and discussion: The results showed that there is a negative correlation Bauman and carrying angle of injured elbow (r=-0.543, p <0.0001). Analyzing Bauman' s angle deviation from value of 75 ° and the loss of carrying angle there is noticed significant positive correlation between the Bauman angle deviation and loss of carrying angle. Bauman' s angle correlates well with the carrying angle and can be used as an indicator of the potential cosmetic complications. Conclusion: Carrying angle of uninjured elbow measured when reviewing a child who has suffered supracondylar fracture, can serve as a useful parameter in the assessment of real Bauman' s angle, thereby the adequacy of fracture reduction on the injured arm.
Functional outcome of carrying angle changes following supracondylar humeral fractures in children
International Journal of Orthopaedics Sciences, 2023
Background: The carrying angle (CA) is the angle created when the long axis of the humerus and the long axis of the stretched supinated forearm intersect. It disappears when the elbow is pronated and flexed. The aim of this work was to study changes of CA of the elbow after supracondylar humeral fractures in children as compared to the unaffected side and assess the functional outcomes related to these possible changes. Methods: This retrospective-prospective study was conducted on 21 children aged more than 5 years to 12 years old, having supracondylar humeral closed fractures within one week from the injury and treated by closed reduction and fixed by two percutaneous K-wires applied from the lateral side, had a change of the elbow CA compared to the other side at the end of minimum follow up period (twelve months after fixation of the fracture). Results: As stated by Flynn's criteria for grading, all cases achieved satisfactory outcomes, 16 patients had excellent outcomes, 4 patients had good outcomes and one patient had fair outcomes, whereas no cases were graded as unsatisfactory outcomes. All parents were totally satisfied with the results, only three patients had a minimal degree of dull pain that just appears when lifting heavy objects, and one case of pin tract infection that was resolved on oral antibiotics. Conclusions: The CA changes following supracondylar humeral fractures managed by closed reduction and K-wires fixation are resulting in satisfactory outcomes represented in good functional outcomes, few complications were reported; they weren't severe and didn't affect the daily living activities of patients.
The incidence and treatment trends of pediatric proximal humerus fractures
BMC Musculoskeletal Disorders, 2019
Background: Proximal humerus fractures comprise approximately 2% of all pediatric fractures. In general, upper extremity fractures have increased in children. However, recent trends of proximal humerus fractures are not analyzed yet. The aim was to study the incidence and treatment trends of proximal humerus fractures in children. Methods: All 300 children, aged < 16 years, who suffered from a proximal humerus fracture in the catchment area of Oulu University Hospital, Finland, between 2005 and 2015, were included. Radiographs were reviewed, and patients, injuries, treatments, and outcomes were comprehensively studied. Annual incidence was based on the child population at risk, which changed between 84.500 and 88.100 in the study time. Results: The annual incidence of childhood proximal humerus fractures was mean 31.4/100,000 and no variation trend was found. The majority (92%) was treated nonoperatively, however, there was an increase of operative fixation from 0 to 16% during the study time (Difference 16, 95% CI 0.3 to 34.9%, P = 0.045). Bayonet displacement increased the risk of surgical fixation up to 16-fold (95% CI 4.8-51.4, P < 0.001) in a multivariate analysis when adjusted with other potential risk factors. Higher age was also associated with operative treatment (P = 0.002). The most usual recreational activities were horse riding, downhill skiing, snowboarding, and trampolining. Conclusion: Contrary to most upper extremity fractures in children, proximal humerus fractures did not increase during the long study period. However, their operative treatment increased compared to nonoperative treatment, but the evidence supporting that trend remains unclear.
2019
Background: Supracondylar fractures of the humerus are the most frequent fractures affecting the paediatric elbow and their correct management is important because they can cause catastrophic complications. Hence; the present study was undertaken for comparing the efficacy of two different techniques of management of Supracondylar Fracture of Humerus in Children. Subjects and Methods: A total of 30 children with displaced supracondylar fractures who presented to the emergency department were recruited in this study. Group 1 consisted of patients who were treated with medial lateral pin fixation, and group 2 consisted of patients who were treated with 2 lateral parallel pin fixations. Treatment was carried out in all the patients under septic conditions under the hands of skilled and experienced orthopaedic surgeons. Outcome was assessed in all the patients and was compared. All the results were summarized in Microsoft excel sheet and were analysed by SPSS software. Results: Mean elbow extension loss among subjects of group 1 was 7.08 degree while among the subjects of group 2 was 7.09 degree. Mean elbow flexion loss among subjects of group 1 was 9.57 degree while among the subjects of group 2 was 10.28 degree. Non-significant results were obtained while comparing the mean elbow extension and elbow flexion loss among subjects of both the study groups. Conclusion: Both the techniques can be used with equal efficacy for treating supracondylar fractures of humerus in children.