Washers do not affect the rate of implant removal or elbow motion in medial epicondyle fractures
| Autor: | J. Todd R. Lawrence, Christopher R. Gajewski, Anthony M. Ascoli, Neeraj M. Patel |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Washer Humeral Fractures Adolescent Elbow Bone Nails Implant removal Screw fixation 03 medical and health sciences Fixation (surgical) Fracture Fixation Internal 0302 clinical medicine Elbow Joint medicine Humans Orthopedics and Sports Medicine Range of Motion Articular Surgical treatment Child Device Removal Retrospective Studies 030222 orthopedics business.industry Surgery medicine.anatomical_structure Treatment Outcome Child Preschool Pediatrics Perinatology and Child Health Female Range of motion business Epicondyle Elbow Injuries 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Journal of pediatric orthopedics. Part B. 28(6) |
| ISSN: | 1473-5865 |
| Popis: | The use of a washer to supplement screw fixation can prevent fragmentation and penetration during the surgical treatment of pediatric medial epicondyle fractures. However, concerns may arise regarding screw prominence and the need for subsequent implant removal. The purpose of this study is to evaluate the impact of washer utilization on the need for hardware removal and elbow range of motion (ROM). All pediatric medial epicondyle fractures treated with a single screw over a 7-year period were queried for this retrospective case-control study. Hardware removal was performed only if the patient experienced a complication or implant-related symptoms that were refractory to non-operative management. Of the 137 patients included in the study, a washer was utilized in 90 (66%). Thirty-one patients (23%) ultimately underwent hardware removal. There was not an increased need for implant removal in those with a washer (P = 0.11). When analyzing a subgroup of 102 athletes only, there was similarly no difference in the rate of implant removal if a washer was used (P = 0.64). Overall, 107 (78%) patients regained full ROM at a mean of 13.9 ± 9.7 weeks after surgery with no significant difference along the lines of washer use. Use of a washer did not affect the need for subsequent implant removal or elbow ROM after fixation of medial epicondyle fractures, even in athletes. If there is concern for fracture fragmentation or penetration, a washer can be included without concern that future unplanned surgeries may be required. |
| Databáze: | OpenAIRE |
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