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Erschienen in: Clinical Orthopaedics and Related Research® 8/2009

01.08.2009 | Original Article

Time of Return of Elbow Motion after Percutaneous Pinning of Pediatric Supracondylar Humerus Fractures

verfasst von: Lewis E. Zionts, MD, Christopher J. Woodson, MD, Nahid Manjra, PA, Charalampos Zalavras, MD

Erschienen in: Clinical Orthopaedics and Related Research® | Ausgabe 8/2009

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Abstract

The most common treatment for displaced pediatric supracondylar humerus fractures is closed reduction and percutaneous pinning. However, the time for return of elbow motion after treatment of these injuries is not well documented. To describe the return of elbow motion after closed reduction and percutaneous pinning of these fractures we retrospectively reviewed 63 patients (age range, 1.6–13.8 years) with displaced supracondylar fractures of the humerus stabilized with either two or three lateral entry pins. Pins were removed by 3 to 4 weeks. No patient participated in formal physical therapy. At each followup, elbow range of motion (ROM) was recorded for the injured and uninjured extremities. Elbow ROM returned to 72% of contralateral elbow motion by 6 weeks after pinning and progressively increased to 86% by 12 weeks, 94% by 26 weeks, and 98% by 52 weeks. After closed reduction and percutaneous pinning of a displaced, uncomplicated, supracondylar humerus fracture, 94% of the child’s normal elbow ROM should be expected by 6 months after pinning. Further improvement may occur up to 1 year postoperatively. This information may be helpful in advising parents what to expect after their child’s injury.
Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
Literatur
1.
Zurück zum Zitat Boone DC, Azen SP, Lin CM, Spence C, Baron C, Lee L. Reliability of goniometric measurements. Phys Ther. 1978;58:1355–1390.PubMed Boone DC, Azen SP, Lin CM, Spence C, Baron C, Lee L. Reliability of goniometric measurements. Phys Ther. 1978;58:1355–1390.PubMed
2.
Zurück zum Zitat Dameron TB Jr. Transverse fractures of distal humerus in children. Instr Course Lect. 1981;30:224–235.PubMed Dameron TB Jr. Transverse fractures of distal humerus in children. Instr Course Lect. 1981;30:224–235.PubMed
3.
Zurück zum Zitat Flynn JC, Matthews JG, Benoit RL. Blind pinning of displaced supracondylar fractures of the humerus in children: sixteen years’ experience with long-term follow-up. J Bone Joint Surg Am. 1974;56:263–272.PubMed Flynn JC, Matthews JG, Benoit RL. Blind pinning of displaced supracondylar fractures of the humerus in children: sixteen years’ experience with long-term follow-up. J Bone Joint Surg Am. 1974;56:263–272.PubMed
4.
Zurück zum Zitat Henrikson B. Supracondylar fracture of the humerus in children: a late review of end-results with special reference to the cause of deformity, disability and complications. Acta Chir Scand Suppl. 1966;369:1–72.PubMed Henrikson B. Supracondylar fracture of the humerus in children: a late review of end-results with special reference to the cause of deformity, disability and complications. Acta Chir Scand Suppl. 1966;369:1–72.PubMed
5.
Zurück zum Zitat Herring J: Upper extremity injuries. In: Herring J, ed. Tachdjian’s Pediatric Orthopaedics. Vol 3. Philadelphia, PA: WB Saunders; 2002:2115–2250. Herring J: Upper extremity injuries. In: Herring J, ed. Tachdjian’s Pediatric Orthopaedics. Vol 3. Philadelphia, PA: WB Saunders; 2002:2115–2250.
6.
Zurück zum Zitat Keppler P, Salem K, Schwarting B, Kinzl L. The effectiveness of physiotherapy after operative treatment of supracondylar humeral fractures in children. J Pediatr Orthop. 2005;25:314–316.PubMedCrossRef Keppler P, Salem K, Schwarting B, Kinzl L. The effectiveness of physiotherapy after operative treatment of supracondylar humeral fractures in children. J Pediatr Orthop. 2005;25:314–316.PubMedCrossRef
7.
Zurück zum Zitat Lee YH, Lee SK, Kim BS, Chung MS, Baek GH, Gong HS, Lee JK. Three lateral divergent or parallel pin fixations for the treatment of displaced supracondylar humerus fractures in children. J Pediatr Orthop. 2008;28:417–422.PubMed Lee YH, Lee SK, Kim BS, Chung MS, Baek GH, Gong HS, Lee JK. Three lateral divergent or parallel pin fixations for the treatment of displaced supracondylar humerus fractures in children. J Pediatr Orthop. 2008;28:417–422.PubMed
8.
Zurück zum Zitat Mazda K, Boggione C, Fitoussi F, Pennecot GF. Systematic pinning of displaced extension-type supracondylar fractures of the humerus in children: a prospective study of 116 consecutive patients. J Bone Joint Surg Br. 2001;83:888–893.PubMedCrossRef Mazda K, Boggione C, Fitoussi F, Pennecot GF. Systematic pinning of displaced extension-type supracondylar fractures of the humerus in children: a prospective study of 116 consecutive patients. J Bone Joint Surg Br. 2001;83:888–893.PubMedCrossRef
9.
Zurück zum Zitat Minkowitz B, Busch MT. Supracondylar humerus fractures: current trends and controversies. Orthop Clin North Am. 1994;25:581–594.PubMed Minkowitz B, Busch MT. Supracondylar humerus fractures: current trends and controversies. Orthop Clin North Am. 1994;25:581–594.PubMed
10.
Zurück zum Zitat Nacht JL, Ecker ML, Chung SM, Lotke PA, Das M. Supracondylar fractures of the humerus in children treated by closed reduction and percutaneous pinning. Clin Orthop Relat Res. 1983;177:203–209.PubMed Nacht JL, Ecker ML, Chung SM, Lotke PA, Das M. Supracondylar fractures of the humerus in children treated by closed reduction and percutaneous pinning. Clin Orthop Relat Res. 1983;177:203–209.PubMed
11.
Zurück zum Zitat Otsuka NY, Kasser JR. Supracondylar fractures of the humerus in children. J Am Acad Orthop Surg. 1997;5:19–26.PubMed Otsuka NY, Kasser JR. Supracondylar fractures of the humerus in children. J Am Acad Orthop Surg. 1997;5:19–26.PubMed
12.
Zurück zum Zitat Paradis G, Lavallee P, Gagnon N, Lemire L. Supracondylar fractures of the humerus in children: technique and results of crossed percutaneous K-wire fixation. Clin Orthop Relat Res. 1993;297:231–237.PubMed Paradis G, Lavallee P, Gagnon N, Lemire L. Supracondylar fractures of the humerus in children: technique and results of crossed percutaneous K-wire fixation. Clin Orthop Relat Res. 1993;297:231–237.PubMed
13.
Zurück zum Zitat Pirone AM, Graham HK, Krajbich JI. Management of displaced extension-type supracondylar fractures of the humerus in children. J Bone Joint Surg Am. 1988;70:641–650.PubMed Pirone AM, Graham HK, Krajbich JI. Management of displaced extension-type supracondylar fractures of the humerus in children. J Bone Joint Surg Am. 1988;70:641–650.PubMed
14.
Zurück zum Zitat Rang M: Elbow. In: Rang M, ed. Children’s Fractures. Philadelphia, PA: JB Lippincott; 1983:152–196. Rang M: Elbow. In: Rang M, ed. Children’s Fractures. Philadelphia, PA: JB Lippincott; 1983:152–196.
15.
Zurück zum Zitat Rothstein JM, Miller PJ, Roettger RF. Goniometric reliability in a clinical setting: elbow and knee measurements. Phys Ther. 1983;63:1611–1615.PubMed Rothstein JM, Miller PJ, Roettger RF. Goniometric reliability in a clinical setting: elbow and knee measurements. Phys Ther. 1983;63:1611–1615.PubMed
16.
Zurück zum Zitat Shim JS, Lee YS. Treatment of completely displaced supracondylar fracture of the humerus in children by cross-fixation with three Kirschner wires. J Pediatr Orthop. 2002;22:12–16.PubMedCrossRef Shim JS, Lee YS. Treatment of completely displaced supracondylar fracture of the humerus in children by cross-fixation with three Kirschner wires. J Pediatr Orthop. 2002;22:12–16.PubMedCrossRef
17.
Zurück zum Zitat Shrader MW. Pediatric supracondylar fractures and pediatric physeal elbow fractures. Orthop Clin North Am. 2008;39:163–171, v.PubMedCrossRef Shrader MW. Pediatric supracondylar fractures and pediatric physeal elbow fractures. Orthop Clin North Am. 2008;39:163–171, v.PubMedCrossRef
18.
Zurück zum Zitat Skaggs DL, Cluck MW, Mostofi A, Flynn JM, Kay RM. Lateral-entry pin fixation in the management of supracondylar fractures in children. J Bone Joint Surg Am. 2004;86:702–707.PubMed Skaggs DL, Cluck MW, Mostofi A, Flynn JM, Kay RM. Lateral-entry pin fixation in the management of supracondylar fractures in children. J Bone Joint Surg Am. 2004;86:702–707.PubMed
19.
Zurück zum Zitat Skaggs DL, Sankar WN, Albrektson J, Vaishnav S, Choi PD, Kay RM. How safe is the operative treatment of Gartland type 2 supracondylar humerus fractures in children? J Pediatr Orthop. 2008;28:139–141.PubMed Skaggs DL, Sankar WN, Albrektson J, Vaishnav S, Choi PD, Kay RM. How safe is the operative treatment of Gartland type 2 supracondylar humerus fractures in children? J Pediatr Orthop. 2008;28:139–141.PubMed
20.
Zurück zum Zitat Topping RE, Blanco JS, Davis TJ. Clinical evaluation of crossed-pin versus lateral-pin fixation in displaced supracondylar humerus fractures. J Pediatr Orthop. 1995;15:435–439.PubMed Topping RE, Blanco JS, Davis TJ. Clinical evaluation of crossed-pin versus lateral-pin fixation in displaced supracondylar humerus fractures. J Pediatr Orthop. 1995;15:435–439.PubMed
21.
Zurück zum Zitat Wilkins KE. The operative management of supracondylar fractures. Orthop Clin North Am. 1990;21:269–289.PubMed Wilkins KE. The operative management of supracondylar fractures. Orthop Clin North Am. 1990;21:269–289.PubMed
Metadaten
Titel
Time of Return of Elbow Motion after Percutaneous Pinning of Pediatric Supracondylar Humerus Fractures
verfasst von
Lewis E. Zionts, MD
Christopher J. Woodson, MD
Nahid Manjra, PA
Charalampos Zalavras, MD
Publikationsdatum
01.08.2009
Verlag
Springer-Verlag
Erschienen in
Clinical Orthopaedics and Related Research® / Ausgabe 8/2009
Print ISSN: 0009-921X
Elektronische ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-009-0724-y

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