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The results of the treatment of the lateral condyle fractures of the humerus in children

Year 2013, Volume: 2 Issue: 3, 191 - 193, 01.09.2013
https://doi.org/10.5505/abantmedj.2013.44127

Abstract

OBJECTIVE: In children humerus lateral condyle fractures are second most common fractures after supracondyler humerus fractures and it is the most commen type inside distal humeral epiphyseal fractures. Because of the important complications such as non – union, mal – union, open reduction and internally fixation is favorable, especially in displaced fractures. In our study, we aimed to compare the results of surgery or conservative treatments of children with humerus lateral condyle fractures.METHODS: For our study, we chose 36 patients with humerus lateral condyle fracture that we treated between July 2009 – September 2012. 6 of them was type I 4 mm fracture. 2 of them were treated with close reduction and percutaneous pinning and 7 of them were treated with open reduction and pinning because of the insufficient reduction with close reduction method. We operated 2 of these 7 patients again and put graft to the fracture site because of non – union. We removed casts at the end of fourth week and started motion and exercise to the elbow joint of patients that we followed up conservatively. We used cast or braces during postoperative period in the patients we treated by surgery. At the end of fourth week we removed casts or braces and started motion and exercise to the elbow joint after surgery. After radiologic signs of union we removed pins. For 6 months from the beginning of treatment, we followed up the patients about range of motion, spur formation, union of fracture event or varus – valgus deformity. RESULTS: 25 patients 69.4 % were male, 11 30.6 % patients were female. Their average age was 5.7 3.4 – 8.1 . Patients were followed up for an average of 25 6 – 24 months. None of them had function loss. But in 14 patients spur formation was seen on lateral humerus. Spur formation was seen in all patients who were treated by open surgery. Spur formation was seen in 5 patients with type II fractures that treated by close surgery. There was more spur formation in patients with type III fractures that treated by open surgery than patients with type III fractures that treated by close surgery. We didn’t re-operate any patient for spur excision. There was a superficial pin – tract infection in 1 patient 2.7 % . Deep pin – tract infection wasn’t seen in any patient. No patient had any varus – valgus deformity or supination – pronation loss when compared with contralateral elbow joint. CONCLUSION: In children humerus lateral condyle fractures that has displacement 2mm or more, needs surgery. In our cases we find similar results about spur formation compared with literature, it was related with the displacement at the beginning as literature says. Similar with literature spur formation didn’t cause any limitation on range of motion.

References

  • Song KS, Waters PM. Lateral condylar humerus fractures: which ones should we fix?. J Pediatr Orthop 2012; 32: 5-9.
  • Graham TJ, Waters PM, Price CT, Mencio GA, Chambers HG, Stanley EA, De la Garza JF, Beaty JH, Kasser JR, Thomp- son GH, Kwon Y,Sarwark JF. Upper Extremity. In: Beaty JH, Kasser JR, editors. Rockwood and Wilkins ’Fractures In Children, 5th ed. Philadelphia, Lippincott Williams and Wilkins, 2001: 267-806.
  • Song KS, kang CH, Min BW, Bae KC, Cho CH. Internal Oblique Radiographs for diagnosis of nondisplaced lateral condylar fractures of the humerus in children. J Bone Joint Surg Am. 2007; 89: 58-63.
  • Kazımoğlu C, Karapınar H, Şener M. TOTBİD (Türk Orto- pedi ve Travmatoloji Birliği Derneği) Dergisi 2008; 3-4: 97- 103.
  • Li WC, Xu RJ. Comparison of Kirschner wires and AO cannulated screw internal fixation for displaced lateral humeral condyle fracture in children. Int Orthop. 2012; 6: 1261-6.
  • Pirker ME, Weinberg AM, Höllwarth ME, Haberlik A. Subsequent displacement of initially nondisplaced and minimally displaced fractures of the lateral humeral condyle in children. J Trauma 2005;6: 1202-7.
  • Beaty JH, Kasser JR. The elbow: physeal fractures, apophyseal injuries of the distal humerus, osteonecrosis of the trochlea, and tcondylar fractures. In: Beaty JH, Kasser JR, eds. Rockwood and Wilkins’ Fractures in Children. Phila- delphia: Lippincott Williams & Wilkins; 2006:591–660.
  • Hasler CC, von LL. Prevention of growth disturbances after fractures of the lateral humeral condyle in children. J Pediatr Orthop B. 2001; 10: 123–130.
  • Koh KH, Seo SW, Kim KM, et al. Clinical and radiographic results of lateral condylar fracture of distal humerus in children. J Pediatr Orthop. 2010; 30: 425–9.
  • Davids JR, Maguire MF, Mubarak SJ, et al. Lateral condy- lar fracture of the humerus following posttraumatic cubitus varus. J Pediatr Orthop. 1994; 14: 466–470.
  • Pribaz JR, Bernthal NM, Wong TC, Silva M. Lateral spur- ring (overgrowth) after pediatric lateral condyle fractures. J Pediatr Orthop. 2012;5:456-60.
  • Canale ST. Fractures And Dislocations In Children. In: Canale ST, Beaty JH editors. Campell’s operative orthopea- dics, Mosby Elsevier, 2008: 1531-1725.

Çocuklarda humerus lateral kondil kırığı tedavi sonuçları

Year 2013, Volume: 2 Issue: 3, 191 - 193, 01.09.2013
https://doi.org/10.5505/abantmedj.2013.44127

Abstract

Amaç: Lateral kondil kırıkları çocuklarda humerus suprakondil kırıklarından sonra 2. sırada, humerus distal epifiz kırıkları içerisinde ise en sık görülen kırıklardır. Yanlış kaynama ve kaynamama gibi önemli komplikasyonları olması nedeniyle özellikle ayrışması fazla olan kırıklarda açık cerrahi ve redüksiyon sonrası fiksasyon ile tedavi edilmesi bu kırıklarda ön plandadır. Çalışmamızda lateral kondil kırığı ile gelen çocuklarda uyguladığımız cerrahi ve konservatif tedavi sonuçlarımızı sunmayı amaçladık. Yöntem: : 2009 Temmuz-2012 Eylül döneminde lateral kondil kırığı tanısı ile tedavi edilen 36 hasta çalışmaya alındı. Bulgular: Hastaların 25’i %69.4 erkek, 11’i %30.6 kız çocuğu olup, yaş ortalamaları 5.7 3,4-8,1 yıl idi. Hastalar ortalama 25 6-24ay ay izlendi. Hiçbir hastada fonksiyon kaybı olmadı. Fakat 14 hastada lateralde spur oluştu. Açık cerrahi yapılanların tümünde spur mevcuttu. Kapalı yapılanlardan tip II kırıklardan 5’sinde görüldü. Tip III kırık olup kapalı yapılanlarda Tip III kırık olup açık cerrahi yapılanlara göre daha küçük boyutta spur saptandı. Tip I kırıklarda spur yoktu. Hiçbir hastaya lateralde oluşan spur nedeni ile cerrahi eksizyon uygulanmadı. Cerrahi uygulanan hastalardan 1'inde %2.7 yüzeyel pin dibi enfeksiyonu görüldü. Sonuç: Çocuk humerus lateral kondil kırıklarında 2mm’nin altındaki kırıklar hariç cerrahi tespit gerekmektedir. Çalışmaya dahil ettiğimiz olgularda lateral spurun görülmesi literatürle benzerlik göstererek başlangıç deplasmanı ile ilişkili olduğu gösterilmiştir. Yine literatürle benzer olarak şupurun oluşması eklem hareketlerinde kısıtlılığa neden olmamıştır.

References

  • Song KS, Waters PM. Lateral condylar humerus fractures: which ones should we fix?. J Pediatr Orthop 2012; 32: 5-9.
  • Graham TJ, Waters PM, Price CT, Mencio GA, Chambers HG, Stanley EA, De la Garza JF, Beaty JH, Kasser JR, Thomp- son GH, Kwon Y,Sarwark JF. Upper Extremity. In: Beaty JH, Kasser JR, editors. Rockwood and Wilkins ’Fractures In Children, 5th ed. Philadelphia, Lippincott Williams and Wilkins, 2001: 267-806.
  • Song KS, kang CH, Min BW, Bae KC, Cho CH. Internal Oblique Radiographs for diagnosis of nondisplaced lateral condylar fractures of the humerus in children. J Bone Joint Surg Am. 2007; 89: 58-63.
  • Kazımoğlu C, Karapınar H, Şener M. TOTBİD (Türk Orto- pedi ve Travmatoloji Birliği Derneği) Dergisi 2008; 3-4: 97- 103.
  • Li WC, Xu RJ. Comparison of Kirschner wires and AO cannulated screw internal fixation for displaced lateral humeral condyle fracture in children. Int Orthop. 2012; 6: 1261-6.
  • Pirker ME, Weinberg AM, Höllwarth ME, Haberlik A. Subsequent displacement of initially nondisplaced and minimally displaced fractures of the lateral humeral condyle in children. J Trauma 2005;6: 1202-7.
  • Beaty JH, Kasser JR. The elbow: physeal fractures, apophyseal injuries of the distal humerus, osteonecrosis of the trochlea, and tcondylar fractures. In: Beaty JH, Kasser JR, eds. Rockwood and Wilkins’ Fractures in Children. Phila- delphia: Lippincott Williams & Wilkins; 2006:591–660.
  • Hasler CC, von LL. Prevention of growth disturbances after fractures of the lateral humeral condyle in children. J Pediatr Orthop B. 2001; 10: 123–130.
  • Koh KH, Seo SW, Kim KM, et al. Clinical and radiographic results of lateral condylar fracture of distal humerus in children. J Pediatr Orthop. 2010; 30: 425–9.
  • Davids JR, Maguire MF, Mubarak SJ, et al. Lateral condy- lar fracture of the humerus following posttraumatic cubitus varus. J Pediatr Orthop. 1994; 14: 466–470.
  • Pribaz JR, Bernthal NM, Wong TC, Silva M. Lateral spur- ring (overgrowth) after pediatric lateral condyle fractures. J Pediatr Orthop. 2012;5:456-60.
  • Canale ST. Fractures And Dislocations In Children. In: Canale ST, Beaty JH editors. Campell’s operative orthopea- dics, Mosby Elsevier, 2008: 1531-1725.
There are 12 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Cengiz Işık This is me

Hüsamettin Çakıcı This is me

Fuat Akpınar This is me

Abdullah Alper Şahin This is me

Yasin Durukan This is me

Publication Date September 1, 2013
Published in Issue Year 2013 Volume: 2 Issue: 3

Cite

APA Işık, C., Çakıcı, H., Akpınar, F., Şahin, A. A., et al. (2013). Çocuklarda humerus lateral kondil kırığı tedavi sonuçları. Abant Medical Journal, 2(3), 191-193. https://doi.org/10.5505/abantmedj.2013.44127
AMA Işık C, Çakıcı H, Akpınar F, Şahin AA, Durukan Y. Çocuklarda humerus lateral kondil kırığı tedavi sonuçları. Abant Med J. September 2013;2(3):191-193. doi:10.5505/abantmedj.2013.44127
Chicago Işık, Cengiz, Hüsamettin Çakıcı, Fuat Akpınar, Abdullah Alper Şahin, and Yasin Durukan. “Çocuklarda Humerus Lateral Kondil kırığı Tedavi sonuçları”. Abant Medical Journal 2, no. 3 (September 2013): 191-93. https://doi.org/10.5505/abantmedj.2013.44127.
EndNote Işık C, Çakıcı H, Akpınar F, Şahin AA, Durukan Y (September 1, 2013) Çocuklarda humerus lateral kondil kırığı tedavi sonuçları. Abant Medical Journal 2 3 191–193.
IEEE C. Işık, H. Çakıcı, F. Akpınar, A. A. Şahin, and Y. Durukan, “Çocuklarda humerus lateral kondil kırığı tedavi sonuçları”, Abant Med J, vol. 2, no. 3, pp. 191–193, 2013, doi: 10.5505/abantmedj.2013.44127.
ISNAD Işık, Cengiz et al. “Çocuklarda Humerus Lateral Kondil kırığı Tedavi sonuçları”. Abant Medical Journal 2/3 (September 2013), 191-193. https://doi.org/10.5505/abantmedj.2013.44127.
JAMA Işık C, Çakıcı H, Akpınar F, Şahin AA, Durukan Y. Çocuklarda humerus lateral kondil kırığı tedavi sonuçları. Abant Med J. 2013;2:191–193.
MLA Işık, Cengiz et al. “Çocuklarda Humerus Lateral Kondil kırığı Tedavi sonuçları”. Abant Medical Journal, vol. 2, no. 3, 2013, pp. 191-3, doi:10.5505/abantmedj.2013.44127.
Vancouver Işık C, Çakıcı H, Akpınar F, Şahin AA, Durukan Y. Çocuklarda humerus lateral kondil kırığı tedavi sonuçları. Abant Med J. 2013;2(3):191-3.