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Register a new userFunctional results of supracondylar fractures of humerus extension type in children Comparative study for percutaneous pinning versus open reduction
النتائج الوظيفية لكسور فوق اللقمتين العضديتين من النمط الباسط عند الأطفال دراسة مقارنة بين نتائج التثبيت بأسياخ عبر الجلد و الرد المفتوح
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Tishreen University ورقة بحثية
Publication date
2016
fields
Medicine
and research's language is
العربية
Authors
علي يوسف( باحث )
Created by
Shamra Editor
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يعتبر التثبيت بأسياخ عبر الجلد مبدأً جديداً و جيداً لتثبيت كسور فوق اللقمتين العضديتين عند الأطفال مع عدم وجود المساوئ المشاهدة في الرد المفتوح. تم إجراء دراسة راجعة و استقبالية لــــــــ 48 طفل تتراوح أعمارهم بين 2 و 14 سنة ممن تم قبولهم و علاجهم جراحيا بشكل مغلق أو مفتوح في مشفى الأسد الجامعي باللاذقية في جامعة تشرين في عام 2014. تراوحت أعمار المرضى بين 2 و 14 سنة, و سيطرة للذكور ( 62.5%) على الإناث (37.5%), كان السبب الشائع هو الحوادث المنزلية و الرياضية, و الجهة المسيطرة هي اليسرى. كانت الكسور معزولة في أكثر من 90% من الحالات و لاحظنا في دراستنا وجود أربع حالات لكسور مرافقة و غير متبدلة في المعصم و الساعد لنفس الجهة (و حيث تم تدبيرها بشكل محافظ في سياق علاج كسر فوق اللقمتين). تم نزع الجبيرة و الأسياخ في الأسبوع الرابع. كانت الإختلاطات الأكثر شيوعا عبارة عن التبدل الثانوي بعد الجراحة و الأذيات العصبية و الإندمال المعيب ( المرفق الأفحج) و تحدد حركة المرفق. و تبقى طريقة التثبيت بأسياخ عبر الجلد سهلة من حيث الفهم و التطبيق و تعطي نتائج جيدة على المدى الطويل على المستوى الجمالي و الوظيفي للمرفق و هي لا تحمل اختلاطات هامة حيث يمكن الوقاية منها.
The fixation of the humeral,s supracondylare fractures in children by percutaneous pinning is considered a new and good principle in without the disadvantages that appear by treating it by open reduction and internal fixation . A prespective and perspective study was done for 48 kids whose old was between 2 – 14 year, those kids were admitted and treated surgically by these two methods ( pinning and ORIF ) In AL-ASSAD hospital in LATTAKIA in TISHREEN-UNIVERSITY in 2014 The ages of patients were between 2 – 14 , female ratio was ( 62.5% ) and male ( 37.5% ) the common reasons for these fractures were sportive and home accidents and the dominant upper limb was left . Fractures were isolate in 90% of cases and we noted 4 cases with accompanied and nondisplaced fractures in forearm and wrist that were treated conservatively . Pins and cast were removed in the four weeks . The more common complications were the secondary displacement , movement limitation and cubitus varus. The percutaneous pinning stills an easy way in understanding and application and gives good results for long period functionally and cosmetically , and this way has no important complications which can be avoided .
References used
Bracq. H, les fractures supracondyliennes de l humerus de l enfant. Conference d enseignement SOFCOT 1991,29- 37. Paris extension scientifique francaise
Hamel A. les fractures recentes de l humerus distal de l enfant conference d enseignement de la SOFCOT 2007
Mazeau P. Dimeglio A. fracture de la palette humerale de l enfant , diagnostic, traitment, complications, revue du praticien 2001.vol.51 n 16 – 1825-1831
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The study included 40 cases of supracondylar humeral fracture in children whose
attended al-Assad University Hospital in Lattakia between 2013 and 2014. Patients' ages
ranged between 2 and 13 years , the ratio of males/female was 3,4/1. Greatest ra
nge of
injury in left arm 77,5% . Closed reduction and percutaneous pinning was used in 33
patients and open reduction with cross-wiring in 7 patients .Postoperative complications
occurred in seven(17,5%) patients. They consisted in iatrogenic nerve injuries in five
(12,5%) patients ,one case of infection around the pins ,and one case of nonunion, All
recovered without sequels.
Satisfactory outcomes were noted after 5 months of physical therapy in 32 (97%)
patients in
the percutaneous pinning group,and5 (71,4%) patients in the open reduction with
cross-wiring group .
Closed reduction and percutaneous pin fixation is considered
standard management for displaced supracondylar fractures of the
humerus in children. However, controversy exists regarding whether
to use pins from the lateral side or medial and latera
l side of the
elbow for fixation .
We performed this research to know the results of two ways of
treatment and to compare : 1- the risk of iatrogenic ulnar nerve
injury caused by pin fixation . 2- quality of fracture reduction in
terms of radiographic outcomes . 3- compare function of the elbow
and other surgical complications caused by pin fixation between two
ways.
Background: Kid's body has major ability for remodeling and correcting all of
displacement that could happened on fractures.There is many ways for treatment of these
fracture,we can put them in tow guidelines:
Surgical treatment, conservative trea
tment.
Aim: Comparison between conservative treatment result and result of surgical
treatment via ESIN in treatment of midshaft forearm fractures in children, and chose the
best method that achieve healing in fast time and with less complications.
Methods: the study included 40 kids ,that have been chosen in random way from
children that came to the ER and clinics in Alassad and Tishreen university hospitals in
time between 2012 and 2017,with age of 9 to 14 years.
Results: The results were similar between conservative treatment and surgical
treatment via esin according to healing ,time at hospital ,and costs .time to return to daily
life is shorter in surgical treatment. complications were found in two methods but there
were no effect on the extremity or the child.
The purpose of this study was to evaluate the reliability of a single malleable noncommpression
titanium miniplate in fixation and stability of fractures of the mandibular
angle using two approaches(.transbuccal and intra-oral approach, or intra-or
ally alone) .
The research sample included 20 patients from patients who attended AL Assad
University Hospital with Unilateral or bilateralun-comminuted mandibular angle fractures
in the period between September 2011 and October 2013.
The research sample was divided into two groups depending on the two approaches
that have been used . Adequacy of the reduction and stability of fixation were evaluated
through Radiographic examinations immediately after surgery. Postoperative assessment
was based on clinical examination after 1 month, 6 monthes and a year to evaluate:
Occlusion, Masticatory efficiency, Maximum mouth opening range, and Other
complications(infection –mini-plate exposure).
The results of the present study showed that there were statistical difference between
the two approaches(transbuccal and intra-oral approach, or intra-orally alone) regarding
Occlusion, Masticatory efficiency and Other complications after 1 and 6 months while
there was no statistical difference between the approaches after 1 year .
we Concluded that using the combined transbuccal/oral approach was the best
regarding(infection and mini-plate exposure) and compared with intra-oral approach .
The study covered 30 cases of patellar fractures in persons who were accepted and treated surgically at Al-Assad University Hospital in Lattakia from 2008 to 2013.Ages of patients ranged between 16-70 years. Average load of clinical and radial conti
nuation was six months. The smaller age of traumatism amounted 16 years and larger age 70 years; average load of age was 37.66 years. The number of traumatism in male was amounted 12 and female 18. In estimating the results, we depend on Lysholm scale scoring. Functional results were studied after 6 months and we had excellent result in 27% of cases and good results in 47% of other cases
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