Compared outcomes after percutaneous pinning versus open reduction in paediatric supracondylar elbow fractures - 02/10/12
, P. Gicquel b, L. Schneider b, C. Stanchina b, C. Karger b, E. Saliba b, O. Ossenou a, J.-M. Clavert b
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Summary |
Background |
Supracondylar fractures of the elbow are common in children. Their treatment is controversial when displacement has occurred, although percutaneous pinning is usually advocated.
Hypothesis |
In paediatric extension-type supracondylar fractures of the elbow, percutaneous pinning and crossed K-wire fixation after open reduction via the medial approach produce similar functional outcomes and complication rates.
Materials and methods |
We retrospectively reviewed the medical charts of 58 children aged 2 to 15 years who underwent surgery for extension-type supracondylar elbow fractures between 2004 and 2008. Closed reduction and percutaneous pinning was used in 33 patients with a mean age of 7 years and 11 months; open reduction with cross-wiring in 25 patients with a mean age of 7 years. Functional outcomes were assessed using Flynn’s criteria. Baumann’s angle was determined and postoperative complications and sequelae were recorded.
Results |
Outcomes were satisfactory in 30 (90.9%) patients treated with percutaneous pinning and in 23 (92%) patients treated with open reduction and cross-wiring. Mean Baumann’s angle at last follow-up was 73.9±5.74° after percutaneous pinning and 74.76±4.07° after open reduction and cross-wiring. Postoperative complications consisted of reoperation in six (10.3%) patients and iatrogenic nerve injury in two (3.4%) patients. Cubitus varus occurred in two (6.06%) patients after closed treatment and in one (4%) patient after open treatment. In each group, three (5.1%) patients had greater than 15° of motion range limitation.
Discussion |
In children with extension-type supracondylar elbow fractures, outcomes are similar with percutaneous pinning and with open reduction via the medial approach followed by cross-wiring.
Level of evidence |
Level IV, retrospective study.
Le texte complet de cet article est disponible en PDF.Keywords : Child elbow fracture, Crossed pinning, Percutaneous pinning, Supracondylar fracture, Surgical treatment
Plan
Vol 98 - N° 6
P. 645-651 - octobre 2012 Retour au numéro
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