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Cannulated Screw Versus Kirschner Wire Fixation Following Open Reduction of Lateral Condyle Fracture of Humerus

Volume 9 | Issue 1 | January-April 2023 | Page: 00-00 | Shane Moe, Hein Latt Win, Kyaw Kyaw, Wai Lin Tun, Ye Htut Aung DOI- https://doi.org/10.13107/ijpo.2023.v09.i01.000 Authors: Shane Moe [1] M.D, Ph.D., Hein Latt Win [2] M.D, Ph.D. FRCS, Kyaw Kyaw [1] M.D, Ph.D., Wai Lin Tun [1] M.D, Ph.D., Ye Htut Aung [2] […]

Atypical Osteoid Osteoma of Proximal Femur and its Surgical Challenges: A Technical Note on ‘Wandering Nidus’ and Double Lesion

Volume 9 | Issue 1 | January-April 2023 | Page: 00-00 | Sitsabesan Chokkalingam, Arunan Murali, Roy Santhosham, Gopinath Menon DOI- https://doi.org/10.13107/ijpo.2023.v09.i01.000 Authors: Sitsabesan Chokkalingam [1] D Ortho., Arunan Murali [2] MD Rad., Roy Santhosham [2] MD Rad., Gopinath Menon [1] MS Ortho. [1] Department of Trauma & Orthopaedics, (SRIHER) Sri Ramachandra Institute of Higher […]

Cannulated Screw Versus Kirschner Wire Fixation Following Open Reduction of Lateral Condyle Fracture of Humerus

Atypical Osteoid Osteoma of Proximal Femur and its Surgical Challenges: A Technical Note on ‘Wandering Nidus’ and Double Lesion

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Cannulated Screw Versus Kirschner Wire Fixation Following Open Reduction of Lateral Condyle Fracture of Humerus

Volume 9 | Issue 1 | January-April 2023 | Page: 00-00 | Shane Moe, Hein Latt Win, Kyaw Kyaw, Wai Lin Tun, Ye Htut Aung

DOI- https://doi.org/10.13107/ijpo.2023.v09.i01.000

Authors: Shane Moe [1] M.D, Ph.D., Hein Latt Win [2] M.D, Ph.D. FRCS, Kyaw Kyaw [1] M.D, Ph.D., Wai Lin Tun [1] M.D, Ph.D.,

Ye Htut Aung [2] M.D

[1] Department of Orthopaedics, DSOH, Yangon, Myanmar.
[2] Department of Orthopaedics, DSMA, Yangon, Myanmar.

Address of Correspondence

Dr. Shane Moe
Consultant Orthopaedic Surgeon, DSOH, Yangon, Myanmar.
E-mail: drshanemoe@gmail.com

Abstract

Background: Lateral condyle fracture (LCF) of the immature humerus is a transphyseal intra-articular injury. Where there is more than two millimeters of displacement, open reduction and internal fixation (ORIF) with anatomic reduction and secure fixation are essential to avoid complications. The aim of this study is to analyze the outcome of cannulated screw versus two divergent Kirschner wire (K-wire) fixation following open reduction of displaced lateral condyle fracture of humerus.
Methods: A prospective randomized controlled trial was performed including 64 children in 2 treatment groups: Group-A (screw fixation) and Group-B (Kirschner wires). Primary outcome measures were radiological outcome and functional outcome. Secondary outcomes were stability of fixation and post-operative complications.
Results: There was no significant difference in demographic characteristics of the children between two groups. Screw fixation was significantly superior in radiological outcome than K-wires. There was no significant difference in functional outcome or the stability of fixation between the two groups. Surgical site infection and lateral condylar overgrowth were significantly higher in the K-wire fixation group.
Conclusion: Cannulated screw fixation is superior in radiological outcome with fewer complications than K-wire fixation in displaced LCF of humerus in children. But there was no significant difference in functional outcome and stability of fixation.
Keywords: Cannulated screw, Kirschner wire, Lateral condyle fracture of Humerus, Children

References

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2. Shirley, E., Anderson, M., Neal, K., & Mazur, J. Screw fixation of lateral condyle fractures: results of treatment. Journal of Pediatric Orthopaedics, 2015; 35(8): 821-824. https://doi.org/10.1097/BPO.0000000000000377
3. Gilbert, S. R., MacLennan, P. A., Schlitz, R. S., & Estes, A. R. Screw versus pin fixation with open reduction of pediatric lateral condyle fractures. Journal of Pediatric Orthopaedics, 2016; 25(2): 148-152.
https://doi.org/ 10.1097/bpb.0000000000000238
4. Stein, B. E., Ramji, A. F., Hassanzadeh, H., Wohlgemut, J. M., Ain, M. C., & Sponseller, P. D. Cannulated lag screw fixation of displaced lateral humeral condyle fractures is associated with lower rates of open reduction and infection than pin fixation. Journal of Pediatric Orthopaedics, 2017; 37(1): 7-13.
https://doi.org/ 10.1097/bpo.0000000000000579
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13. Singh, R. S., Garg, L., Jaiman, A., Sharma, V. K., & Talwar, J. Comparison of kirschner wires and cannulated screw internal fixation for displaced lateral humeral condyle fracture in skeletally immature patients. Journal of Clinical Orthopaedics & Trauma, 2015; 6(1): 62.
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16. Franks, D., Shatrov, J., Symes, M., Little, D. G., & Cheng, T. L. (2018). Cannulated screw versus Kirschner-wire fixation for Milch II lateral condyle fractures in a paediatric sawbone model: a biomechanical comparison. Journal of Children’s Orthopaedics, 12(1), 29-35. https://doi.org/10.1302/1863-2548.12.170090
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How to Cite this Article: Moe S, Win HL, Kyaw K, Tun WL, Aung YH | Cannulated Screw Versus Kirschner Wire Fixation Following Open Reduction of Lateral Condyle Fracture of Humerus | International Journal of Paediatric Orthopaedics| January-April 2023; 9(1): 00-00 | https://doi.org/10.13107/ijpo.2023.v09.i01.000https://doi.org/10.13107/ijpo.2023.v09.i01.000

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Atypical Osteoid Osteoma of Proximal Femur and its Surgical Challenges: A Technical Note on ‘Wandering Nidus’ and Double Lesion

Volume 9 | Issue 1 | January-April 2023 | Page: 00-00 | Sitsabesan Chokkalingam, Arunan Murali, Roy Santhosham, Gopinath Menon

DOI- https://doi.org/10.13107/ijpo.2023.v09.i01.000

Authors: Sitsabesan Chokkalingam [1] D Ortho., Arunan Murali [2] MD Rad., Roy Santhosham [2] MD Rad., Gopinath Menon [1] MS Ortho.

[1] Department of Trauma & Orthopaedics, (SRIHER) Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, Tamil Nadu, India.
[2] Department of Radiology, (SRIHER) Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, Tamil Nadu, India.

Address of Correspondence

Dr. Sitsabesan Chokkalingam,
Department of Trauma & Orthopaedics, (SRIHER) Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, Tamil Nadu, India.
E-mail: sabesan101@gmail.com

Abstract

Introduction: Osteoid osteomas are painful benign bone tumors, accounting for 10% of overall primary bone tumors. Typical osteoid osteomas are located intracortical or intramedullary in the metadiaphyseal region of the long bones. The Atypical ones are the Juxta and Intraarticular type, posing greater challenges in its diagnosis and management. CT and MRI scans have better chances of defining the nidus lesions in Atypical osteoid osteoma of the hip joints. Surgical treatment options include, image guided percutaneous interventions such as Radio frequency ablation, Laser or Cryo ablation. These modalities achieve surgical cure, but lacks the opportunity for a histo-pathological confirmation. Our cases will highlight the ‘wandering nidus’ in hip osteoid osteoma and the possibility of dual pathology (Osteoid osteoma and Osteomyelitis) in the same hip.
Case study: We present two cases of hip joint osteoid osteomas (aged 18 yrs and 10 yrs) to highlight the diagnostic challenges and to discuss the different methodology of treatment. CT scan with additional MRI studies confirmed the radiological diagnosis after a delay of 6-8 months. The first case will highlight the wandering nature of the nidus (explained by the position of the calcific spicule within the nidus with reference to the needle tip), the challenges for needle trajectory with close proximity to femoral vessels and the “coaxial technique using chopstick maneuver” for CT guided needle excision. The second case will highlight the feasibility of percutaneous excision and surgical curettage in the presence of dual pathology.
Conclusion: Both the cases were successfully treated by CT guided n excision biopsy and had the histopathological confirmation. Needle technique allows confirmation of diagnosis and exclusion of other differential pathology.
Keywords: Wandering nidus, Atypical osteoid osteoma hip, Chopstick maneuver, Coaxial technique, Double hip lesion.

References

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[2] Ciftdemir M, Tuncel SA, Usta U. Atypical osteoid osteomas. Eur J Orthop Surg Traumatol. 2015 Jan;25(1):17-27. doi: 10.1007/s00590-013-1291-1. Epub 2013 Aug 23. PMID: 23975583.
[3] Kayser F, Resnick D, Haghighi P, Pereira ER, Greenway G, Schweitzer M, et al. Evidence of the subperiosteal origin of osteoid osteomas in tubular bones: analysis by CT and MR imaging. AJR Am J Roentgenol. 1998;170(3):609–614. doi: 10.2214/ajr.170.3.9490939
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[6] D. I. Rosenthal, F. J. Hornicek, M. Torriani, M. C. Gebhardt, and H. J. Mankin, “Osteoid osteoma: percutaneous treatment with radiofrequency energy,” Radiology, vol. 229, no. 1, pp. 171–175
[7] Chai JW, Hong SH, Choi JY, Koh YH, Lee JW, Choi JA et al (2010) Radiologic diagnosis of osteoid osteoma: from simple to challenging fndings. Radiographics 30(3):737–749
[8] Davies M, Cassar-Pullicino VN, Davies AM, McCall IW, Tyrrell PN (2002) The diagnostic accuracy of MR imaging in osteoid osteoma. Skeletal Radiol 31(10):559–569
[9] Mungo DV, Zhang X, O’Keefe RJ, Rosier RN, Puzas JE, Schwarz EM (2002) COX-1 and COX-2 expression in osteoid osteomas. J Orthop Res 20(1):159–162
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[12] Aynaci, O., Turgutoglu, O., Kerimoglu, S. et al. Osteoid osteoma with a multicentric nidus: a case report and review of the literature. Arch Orthop Trauma Surg 127, 863–866 (2007). https://doi.org/10.1007/s00402-007-0421-9

How to Cite this Article: Chokkalingam S, Murali A, Santhosham R, Menon G | Atypical Osteoid Osteoma of Proximal Femur and Its Surgical Challenges: A Case Study on ‘Wandering Nidus’ and Double Lesion | International Journal of Paediatric Orthopaedics | January-April 2023; 9(1): 00-00 | https://doi.org/10.13107/ijpo.2023.v09.i01.000

Half Sized Blog Element (Single Author Style)

Half Sized Blog Element (Multi Author Style)

Cannulated Screw Versus Kirschner Wire Fixation Following Open Reduction of Lateral Condyle Fracture of Humerus

Atypical Osteoid Osteoma of Proximal Femur and its Surgical Challenges: A Technical Note on ‘Wandering Nidus’ and Double Lesion

Cannulated Screw Versus Kirschner Wire Fixation Following Open Reduction of Lateral Condyle Fracture of Humerus

Atypical Osteoid Osteoma of Proximal Femur and its Surgical Challenges: A Technical Note on ‘Wandering Nidus’ and Double Lesion

Full Sized Blog Element (Big Preview Pic)

Cannulated Screw Versus Kirschner Wire Fixation Following Open Reduction of Lateral Condyle Fracture of Humerus

Abstract

(Article Text HTML) (Full Text PDF)

Atypical Osteoid Osteoma of Proximal Femur and its Surgical Challenges: A Technical Note on ‘Wandering Nidus’ and Double Lesion

Authors: Sitsabesan Chokkalingam [1] D Ortho., Arunan Murali [2] MD Rad., Roy Santhosham [2] MD Rad., Gopinath Menon [1] MS Ortho.

Abstract

(Article Text HTML) (Full Text PDF)

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