9 years' follow-up of 168 pin-fixed supracondylar humerus fractures in children
| Autor: | Antti Sommarhem, Noora Tuomilehto, Aarno Y Nietosvaara |
|---|---|
| Přispěvatelé: | Clinicum, I kirurgian klinikka (Töölö), Department of Surgery, Children's Hospital, Lastentautien yksikkö, Lastenkirurgian yksikkö, HUS Children and Adolescents, HUS Musculoskeletal and Plastic Surgery |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Humeral Fractures Adolescent NEUROVASCULAR COMPLICATIONS Shoulder and Children Bone Nails 03 medical and health sciences Fracture Fixation Internal 0302 clinical medicine 3123 Gynaecology and paediatrics NERVE INJURIES medicine Humans Orthopedics and Sports Medicine Humerus 030212 general & internal medicine Range of Motion Articular Child Orthopedic surgery 030222 orthopedics business.industry Infant General Medicine ANGLE 3126 Surgery anesthesiology intensive care radiology Surgery medicine.anatomical_structure Treatment Outcome Patient Satisfaction Child Preschool Female business RD701-811 Follow-Up Studies |
| Zdroj: | Acta Orthopaedica Acta Orthopaedica, Vol 89, Iss 3, Pp 351-356 (2018) |
| Popis: | Background and purpose - The long-term outcome of pin-fixed supracondylar humerus fractures (SCHF) in children is not well known. We assessed the 7- to 12-year outcome in 168 children. Patients and methods - During 2002-2006, 210 domestic children (age 7 (1-14) years) with SCHF (Gartland III 79%, Gartland II 19%, and flexion type 2%) were pin fixed in Helsinki. 36 (17%) patients had a nerve palsy. Radiographic alignment was regarded as satisfactory in 81% of patients (Baumann angle (BA) within 10 of normal range and whose anterior humeral line (AHL) crossed the capitulum). After a mean follow-up of 9 (7-12) years, 168 (80%) patients answered a questionnaire regarding elbow appearance (scale 0-10), function (scale 0-10), and pain (scale 0-10), and symmetry of range of motion (ROM) and carrying angle (CA). 65 (31%) patients also attended a clinical follow-up examination. Results - Mean subjective score for appearance was 8.7 (2-10) and for function 9.0 (2-10) (n = 168). Elbow ROM asymmetry was experienced by 28% and elbow CA asymmetry by 17% of the patients. Elbow pain was reported by 14%, and was more common in children with nerve injuries. Long-term outcome was good or excellent in 60/65 and CA in 56/65 of the follow-up visit patients using Flynn's criteria. BA exceeding normal values by 10 was associated with lower subjective outcome; AHL crossing point with the capitulum was not associated with outcome. Interpretation - Long-term subjective outcome is satisfactory with few exceptions if elbow ROM and CA are restored within 10 degrees of the uninjured elbow. Radiographs at fracture union have little prognostic value. Nerve injuries can cause long-term pain. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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