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Çekilmiş Dirsek Sendromunda Radyolojik Analizin Gerekliliğinin İncelenmesi

Year 2023, Volume: 8 Issue: 2, 200 - 205, 06.06.2023
https://doi.org/10.26453/otjhs.1199258

Abstract

Amaç: Birinci amaç, çekilmiş dirsek hastalarının yaralanmış ve sağlam taraflarının radyolojik bulgularındaki farklılıkları araştırarak radyolojik incelemenin bu hastalardaki gerekliliğini ortaya koymaktır. İkinci amaç, nüks ile ilişkili risk faktörlerini ortaya çıkarmaktır.
Materyal ve Metot: Bu retrospektif prognostik çalışmada, Ağustos 2019 ile Ocak 2022 tarihleri arasında çekilmiş dirsek nedeniyle tedavi edilen 80 hasta incelendi. Hastaların cinsiyeti, yaşı, tarafı ve yaralanma mekanizması bilgileri değerlendirildi. Radyo-kapitellar hat, radyal epifiz açı ve humero-ulnar açı hem kırık hem de sağlam taraf grafilerinde değerlendirildi.
Bulgular: Radyolojik analizde gözden kaçmış kırık saptanmadı ve yaralı ve sağlam taraflar arasında radyolojik açıdan anlamlı fark bulunmadı (p>0,05). 14 hastada (%17,5) tekrarlayan çekilmiş dirsek saptandı. Tekrarlayan çekilmiş dirsek ile cinsiyet, taraf, yaralanma mekanizması ve radyolojik bulgular arasında anlamlı bir ilişki bulunmadı (p>0,05).
Sonuç: Çekilmiş dirseğin radyografik değerlendirilmesi tanısal ve prognostik olarak gerekli olmasa da kırık ekartasyonu ve medikolegal kaygılar açısından radyografik incelemeler gerekebilir. Tekrarlayan çıkığı öngören belirgin bir risk faktörü yoktur.

References

  • 1. Halsey MF. Paediatric pulled elbow injury: more common and recurrent than you think. Acta Paediatr. 2018;107(11):1850. doi:10.1111/apa.14500
  • 2. Yamanaka S, Goldman RD. Pulled elbow in children. Can Fam Physician. 2018;64(6):439-441
  • 3. Dogan O, Caliskan E, Gencer B, Bicimoglu A. Is male gender a prognostic factor for developmental dysplasia of the hip? Mid-long-term results of posteromedial limited surgery. Acta Orthop Traumatol Turc. 2019;53(5):340-345. doi:10.1016/j.aott.2019.05.001
  • 4. Gencer B, Doğan Ö, Çulcu A, Biçimoğlu A. Redislocation After Posteromedial Open Reduction in Developmental Dysplasia of the Hip: Analyzing the Risk Factors and Determining the Optimal Treatment Method. J Pediatr Orthop. 2022;42(9):474-481. doi:10.1097/BPO.0000000000002234
  • 5. Ulici A, Herdea A, Carp M, Nahoi CA, Tevanov I. Nursemaid's Elbow - Supination-flexion Technique Versus Hyperpronation/forced Pronation: Randomized Clinical Study. Indian J Orthop. 2019;53(1):117-121. doi:10.4103/ortho.IJOrtho_442_17
  • 6. Bek D, Yildiz C, Köse O, Sehirlioğlu A, Başbozkurt M. Pronation versus supination maneuvers for the reduction of 'pulled elbow': a randomized clinical trial. Eur J Emerg Med. 2009;16(3):135-138. doi:10.1097/MEJ.0b013e32831d796a
  • 7. Krul M, van der Wouden JC, Kruithof EJ, van Suijlekom-Smit LW, Koes BW. Manipulative interventions for reducing pulled elbow in young children. Cochrane Database Syst Rev. 2017;7(7):CD007759. Published 2017 Jul 28. doi:10.1002/14651858.CD007759.pub4
  • 8. Varga M, Papp S, Kassai T, Bodzay T, Gáti N, Pintér S. Two- plane point of care ultrasonography helps in the differential diagnosis of pulled elbow. Injury. 2021;52 Suppl 1:S21-S24. doi:10.1016/j.injury.2020.02.032
  • 9. Wong K, Troncoso AB, Calello DP, Salo D, Fiesseler F. Radial Head Subluxation: Factors Associated with Its Recurrence and Radiographic Evaluation in a Tertiary Pediatric Emergency Department. J Emerg Med. 2016;51(6):621-627. doi:10.1016/j.jemermed.2016.07.081
  • 10. Hanes L, McLaughlin R, Ornstein AE. Suspected Radial Head Subluxation in Infants: The Need for Radiologic Evaluation. Pediatr Emerg Care. 2021;37(1):e58-e59. doi:10.1097/PEC.0000000000001848
  • 11. Radiopedia. Radiocapitellar line. https://radiopaedia.org/articles/radiocapitellar-line. Accessed November 2, 2022.
  • 12. Suangyanon P, Chalayon O, Worawuthangkul K, Kaewpornsawan K, Ariyawatkul T, Eamsobhana P. Pediatric elbow measurement parameters: Evaluation of the six angles in inter- and intra-observer reliability. J Clin Orthop Trauma. 2019;10(4):792-796. doi:10.1016/j.jcot.2018.07.019
  • 13. Lee YS, Sohn YD, Oh YT. New, specific ultrasonographic findings for the diagnosis of pulled elbow. Clin Exp Emerg Med. 2014;1(2):109-113. doi:10.15441/ceem.14.009
  • 14. Dohi D. Confirmed specific ultrasonographic findings of pulled elbow. J Pediatr Orthop. 2013;33(8):829-831. doi:10.1097/BPO.0000000000000087
  • 15. Lee SH, Kim SG, Kwak D, Hong SH, Lee YK, Jang WY. The usefulness of ultrasound and the posterior fat pad sign in pulled elbow. Injury. 2019;50(6):1227-1231. doi:10.1016/j.injury.2019.04.026
  • 16. Gencer B, Doğan Ö. Consequences of the COVID-19 pandemic on fracture distribution: Epidemiological data from a tertiary trauma center in Turkey. J. Exp. Clin. Med. 2022;39(1):128-133. doi: 10.52142/omujecm.39.1.26

Investigating the Necessity of Radiological Analysis in Pulled Elbow

Year 2023, Volume: 8 Issue: 2, 200 - 205, 06.06.2023
https://doi.org/10.26453/otjhs.1199258

Abstract

Objective: Primary objective was to reveal the necessity of radiological analysis by investigating the differences in radiological findings in the pulled and intact sides of pulled elbow patients. The secondary goal was to examine pulled elbow patients' demographic and radiographic distributions to reveal recurrence-related risk factors.
Materials and Methods: In this retrospective prognostic study, 80 patients, treated for pulled elbow between August 2019 and January 2022 were examined. The patient's gender, age, side, and injury mechanism information were evaluated. The radio-capitellar line, the radial epiphyseal angle, and the humero-ulnar angle were evaluated on both injured and intact side X-rays.
Results: No missed fractures were detected, and no significant difference was found between injured and intact sides in the radiological analysis (p>0.05). Recurrent dislocations were detected in 14 patients (17.5%). No significant relationship was found between recurrent pulled elbow and gender, side, mechanism of injury, and radiological findings (p>0.05).
Conclusion: Although radiographic examination of the pulled elbow is not diagnostically and prognostically necessary, radiographs of the elbow can be taken and examined regarding fracture exclusion and medicolegal concerns. There is no obvious risk factor predicting recurrent dislocation.

References

  • 1. Halsey MF. Paediatric pulled elbow injury: more common and recurrent than you think. Acta Paediatr. 2018;107(11):1850. doi:10.1111/apa.14500
  • 2. Yamanaka S, Goldman RD. Pulled elbow in children. Can Fam Physician. 2018;64(6):439-441
  • 3. Dogan O, Caliskan E, Gencer B, Bicimoglu A. Is male gender a prognostic factor for developmental dysplasia of the hip? Mid-long-term results of posteromedial limited surgery. Acta Orthop Traumatol Turc. 2019;53(5):340-345. doi:10.1016/j.aott.2019.05.001
  • 4. Gencer B, Doğan Ö, Çulcu A, Biçimoğlu A. Redislocation After Posteromedial Open Reduction in Developmental Dysplasia of the Hip: Analyzing the Risk Factors and Determining the Optimal Treatment Method. J Pediatr Orthop. 2022;42(9):474-481. doi:10.1097/BPO.0000000000002234
  • 5. Ulici A, Herdea A, Carp M, Nahoi CA, Tevanov I. Nursemaid's Elbow - Supination-flexion Technique Versus Hyperpronation/forced Pronation: Randomized Clinical Study. Indian J Orthop. 2019;53(1):117-121. doi:10.4103/ortho.IJOrtho_442_17
  • 6. Bek D, Yildiz C, Köse O, Sehirlioğlu A, Başbozkurt M. Pronation versus supination maneuvers for the reduction of 'pulled elbow': a randomized clinical trial. Eur J Emerg Med. 2009;16(3):135-138. doi:10.1097/MEJ.0b013e32831d796a
  • 7. Krul M, van der Wouden JC, Kruithof EJ, van Suijlekom-Smit LW, Koes BW. Manipulative interventions for reducing pulled elbow in young children. Cochrane Database Syst Rev. 2017;7(7):CD007759. Published 2017 Jul 28. doi:10.1002/14651858.CD007759.pub4
  • 8. Varga M, Papp S, Kassai T, Bodzay T, Gáti N, Pintér S. Two- plane point of care ultrasonography helps in the differential diagnosis of pulled elbow. Injury. 2021;52 Suppl 1:S21-S24. doi:10.1016/j.injury.2020.02.032
  • 9. Wong K, Troncoso AB, Calello DP, Salo D, Fiesseler F. Radial Head Subluxation: Factors Associated with Its Recurrence and Radiographic Evaluation in a Tertiary Pediatric Emergency Department. J Emerg Med. 2016;51(6):621-627. doi:10.1016/j.jemermed.2016.07.081
  • 10. Hanes L, McLaughlin R, Ornstein AE. Suspected Radial Head Subluxation in Infants: The Need for Radiologic Evaluation. Pediatr Emerg Care. 2021;37(1):e58-e59. doi:10.1097/PEC.0000000000001848
  • 11. Radiopedia. Radiocapitellar line. https://radiopaedia.org/articles/radiocapitellar-line. Accessed November 2, 2022.
  • 12. Suangyanon P, Chalayon O, Worawuthangkul K, Kaewpornsawan K, Ariyawatkul T, Eamsobhana P. Pediatric elbow measurement parameters: Evaluation of the six angles in inter- and intra-observer reliability. J Clin Orthop Trauma. 2019;10(4):792-796. doi:10.1016/j.jcot.2018.07.019
  • 13. Lee YS, Sohn YD, Oh YT. New, specific ultrasonographic findings for the diagnosis of pulled elbow. Clin Exp Emerg Med. 2014;1(2):109-113. doi:10.15441/ceem.14.009
  • 14. Dohi D. Confirmed specific ultrasonographic findings of pulled elbow. J Pediatr Orthop. 2013;33(8):829-831. doi:10.1097/BPO.0000000000000087
  • 15. Lee SH, Kim SG, Kwak D, Hong SH, Lee YK, Jang WY. The usefulness of ultrasound and the posterior fat pad sign in pulled elbow. Injury. 2019;50(6):1227-1231. doi:10.1016/j.injury.2019.04.026
  • 16. Gencer B, Doğan Ö. Consequences of the COVID-19 pandemic on fracture distribution: Epidemiological data from a tertiary trauma center in Turkey. J. Exp. Clin. Med. 2022;39(1):128-133. doi: 10.52142/omujecm.39.1.26
There are 16 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research article
Authors

Batuhan Gencer 0000-0003-0041-7378

İhsaniye Süer Doğan 0000-0002-7586-0537

Nuri Koray Ülgen 0000-0003-0301-3432

Mehmet Murat Arslan 0000-0003-0764-0863

Özgür Doğan 0000-0002-5913-0411

Early Pub Date May 31, 2023
Publication Date June 6, 2023
Submission Date November 4, 2022
Acceptance Date May 9, 2023
Published in Issue Year 2023 Volume: 8 Issue: 2

Cite

AMA Gencer B, Süer Doğan İ, Ülgen NK, Arslan MM, Doğan Ö. Investigating the Necessity of Radiological Analysis in Pulled Elbow. OTJHS. June 2023;8(2):200-205. doi:10.26453/otjhs.1199258

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