12/20/2023 0 Comments Flexion type supracondylar fracture![]() ![]() Inclusion criteria: Patients below 10 years Type II, III or IV supracondylar humeral fractures. Informed consent was obtained from family members. This study was approved by the institutional review board. 64 patients were treated with CRPP under ultrasound guidence, 31 patients were treated with CRPP under radiography guidence. In the present study, a total of 95 children with supracondylar humeral fractures who were treated by CRPP in our hospital from 2017 to 2019 were retrospectively analyzed. Stress testing and the use of ultrasound scanner are also helpful in assessing the stability of the reduction. Multiple ultrasound images can identify a hinge of soft tissue at the fracture site. To reduce radiation exposures, we adopted intraoperative ultrasound to guide the CRPP. However, intraoperative radiographs increase the exposures to both patients and operators. Closed reduction and percutaneous pinning(CRPP) under the guidance of the intraoperative radiographs is an effective therapeutic strategy for supracondylar humeral fractures. In 1948, Swenson first reported the treatment of supracondylar humeral fractures by closed reduction with K-wire fixation. Supracondylar humerus fractures may cause severe acute morbidity and complications, such as nerve injury and vascular injury. Type I: Fracture is nondisplaced, which is treated by cast immobilization Type II: Fracture presents slight displacement with a posterior humeral cortical contact (IIa) or when the fracture presents a straight or rotatory displacement with contact between the two fragments (IIb) Type III: Fractures have a posteromedial or posterolateral displacement associated with a loss of integrity of the posterior cortex Type IV: Fractures with multidirectional instability. According to the Gartland classification, extension supracondylar humeral fractures are categorized into four types. The extension type of supracondylar humeral fractures is caused by elbow hyperextension and the distal end of the fracture is displaced backward and upward While the flexion type is caused by elbow flexion with the olecranon fossa touching the ground, and the distal end of the fracture is displaced forward and upward. Supracondylar humeral fractures are classified into the extension type (98%) and flexion type (2%). After falling from high place, the outstretched hand touching the ground suffers a violence transmitted to the weak olecranon fossa, thus causing a fracture. They are usually caused by hyperextension or flexion violence from falling during activities. The occurrence of pediatric supracondylar humeral fractures has a close relation to the season, and the incidence is high in summer. Supracondylar humeral fractures are the most-common elbow fractures in children, accounting for 60–70% of pediatric elbow fractures, which mainly affect children in 5–8 years. Trial registration Retrospectively registered. Ultrasound-guided CRPP is a safe and reliable surgical treatment of pediatric supracondylar humeral fractures. No cases with Volkmann’s contracture were reported. ![]() One patient had ulnar nerve neurapraxia in the radiography group. After surgery, three patients had pin tract infection. The mean duration of surgery was 58.3 min (42–108 min) in the ultrasound group and 41.5 min (24-63 min) in the radiography group ( P 0.05). A follow-up examination was performed and all the patients were evaluated according to Flynn’s criteria. Percutaneous pinning was performed after supracondylar humeral fractures were well reduced. The reduction effect of supracondylar humeral fractures was determined through the perioperative ultrasound images of the lateral, medial and posterior aspects of the elbow. MethodsĦ4 children with supracondylar humeral fractures were treated with ultrasound-guided closed reduction and percutaneous pinning (CRPP), 31 patients were treated with CRPP under radiography guidence. This study aims to analyze the application value of ultrasound in the surgical treatment of supracondylar humeral fractures. Ultrasound examination can be applied to the diagnosis of pediatric elbow fracture. ![]()
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