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Outcomes in Paediatric Proximal Third Forearm Fractures: A Systematic Review

Volume 10 | Issue 3 | September-December 2024 | Page: 2-5 | Nathan McKenzie, Connor Zale, Ryan Nguyen, Kevin Krul DOI- https://doi.org/10.13107/ijpo.2024.v10.i03.198 Open Access License: CC BY-NC 4.0 Copyright Statement: Copyright © 2024; The Author(s). Submitted: 14/11/2024; Reviewed: 20/11/2024; Accepted: 04/12/2024; Published: 10/12/2024 Authors: Nathan McKenzie B.S. [2], Connor Zale M.D. [1], Ryan Nguyen B.S. […]

Lower Limb Deformity Management in Arthrogryposis – What to Correct and When

Volume 10 | Issue 2 | May-August 2024 | Page: 40-47 | Ishani P Shah, Sujika Ranmuthuge, Varun Parnami, Anastasios Chytas DOI- https://doi.org/10.13107/ijpo.2024.v10.i02.192 Submitted: 18/05/2024; Reviewed: 06/06/2024; Accepted: 16/07/2024; Published: 10/08/2024 Authors: Ishani P Shah DNB Ortho. FRCS (T & O) [1], Sujika Ranmuthuge MD, FRCS (T & O) [1], Varun Parnami DNB Ortho. [1], […]

Outcomes in Paediatric Proximal Third Forearm Fractures: A Systematic Review

Lower Limb Deformity Management in Arthrogryposis – What to Correct and When

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Outcomes in Paediatric Proximal Third Forearm Fractures: A Systematic Review

Volume 10 | Issue 3 | September-December 2024 | Page: 2-5 | Nathan McKenzie, Connor Zale, Ryan Nguyen, Kevin Krul

DOI- https://doi.org/10.13107/ijpo.2024.v10.i03.198

Open Access License: CC BY-NC 4.0

Submitted: 14/11/2024; Reviewed: 20/11/2024; Accepted: 04/12/2024; Published: 10/12/2024

Authors: Nathan McKenzie B.S. [2], Connor Zale M.D. [1], Ryan Nguyen B.S. [3], Kevin Krul M.D. [1]

[1] Tripler Army Medical Center. 1 Jarrett White Rd. Medical Center. Honolulu, HI. 96859.
[2] University of Oklahoma College of Medicine. 800 Stanton L Young Blvd. Oklahoma City, OK. 73117.
[3] John A. Burns School of Medicine. University of Hawaii. 651 lalo St, Honolulu, HI 96813.

Address of Correspondence

Dr. Connor Zale,
Tripler Army Medical Center. 1 Jarrett White Rd. Medical Center. Honolulu, HI. 96859.
Email: Connor.zale11@gmail.com

Abstract

Objective: To analyze initial treatment failure, functional and radiographic outcomes following non-operative management of Paediatric third proximal forearm fractures.
Methods: A search was performed on PUBMED/MEDLINE, Cochrane Database and Embase on 28 January 2024. Search keywords were “Paediatric, proximal, forearm and fracture”. Articles were reviewed for non-operative management of proximal forearm fractures. Articles were reviewed for acceptable angulation for successful treatment, rate of conversion to operative management or remanipulation, functional outcomes and final radiographic angulation.
Results: 181 articles were obtained from a literature search. 10 articles had incomplete data. 10 articles reported the rate for initial treatment failure. 4 articles reported individual patient functional outcomes. 3 articles reported individual residual angulation.
There were 392 cases of proximal forearm fractures. The rate of initial treatment failure which required remanipulation or surgery ranged from 0-83.8%. Individual functional outcomes were reported for 22 patients. The average age was 10.93.9 years old. 16/22 cases had full range of motion. The 6 cases with limited range of motion had residual angulation of 5-15 (11.54.2). 3/5 cases with 15 of residual angulation had full range of motion.
Conclusion: The rate of initial non-operative treatment failure ranged from 0-83.8% for proximal forearm fractures. Families should be advised on the high rate of failure for initial non-operative management and the possible need for remanipulation or surgery. Patients that are 10 years and older are at an increased risk for loss of reduction and possible need for surgical treatment.
Keywords: Both bone, Proximal third forearm, Paediatric forearm fracture

References

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10. Price CT, Scott DS, Kurzner ME, Flynn JC (1990) Malunited forearm fractures in children. J Paediatr Orthop 10:705–712. https://doi.org/10.1097/01241398-199011000-00001
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12. Williams K, Whyte N, Carl JR, et al (2023) Predictors for operative treatment in Paediatric proximal third both-bone diaphyseal forearm fractures in children include age and translation, but not initial angulation. J Child Orthop 17:156–163. https://doi.org/10.1177/18632521231156941
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How to Cite this Article: McKenzie N, Zale C, Nguyen R, Krul K Outcomes in Paediatric Proximal Third Forearm Fractures: A Systematic Review | International Journal of Paediatric Orthopaedics | September-December 2024;10(3):2-5.

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Lower Limb Deformity Management in Arthrogryposis – What to Correct and When

Volume 10 | Issue 2 | May-August 2024 | Page: 40-47 | Ishani P Shah, Sujika Ranmuthuge, Varun Parnami, Anastasios Chytas

DOI- https://doi.org/10.13107/ijpo.2024.v10.i02.192

Submitted: 18/05/2024; Reviewed: 06/06/2024; Accepted: 16/07/2024; Published: 10/08/2024

Authors: Ishani P Shah DNB Ortho. FRCS (T & O) [1], Sujika Ranmuthuge MD, FRCS (T & O) [1], Varun Parnami DNB Ortho. [1], Anastasios Chytas MD, MSc [1]

[1] Department of Paediatric Orthopaedic Surgery, Royal Manchester Children’s Hospital, Oxford Road, M13 9WL

Address of Correspondence

Dr. Ishani P Shah,
Consultant Paediatric Orthopaedic Surgeon, Royal Manchester Children’s Hospital, Oxford Road, M13 9WL.
E-mail: ishanipshah@gmail.com

Abstract

Arthrogryposis is a descriptive term involving non – progressive joint contractures of two or more joints at birth. It is associated with more than 300 diseases. Lower limb involvement is seen in about 95% of the cases with variable affection of the foot, knee and hip. Management depends on the severity, affection of number of joints and co-morbidities. Multidisciplinary management is crucial with realistic expectations. Prognosis should be discussed with parents prior to undertaking surgical intervention, especially the risk of recurrence as age advances. Deformities include soft tissue contractures, fibrotic hypoplastic muscles and in older children, deformed articular congruity. Foot is most commonly affected and Ponseti casting is the gold standard first line of treatment. Failed correction or late presentations are treated with soft tissue/bony surgery and/or fixator. Knee contractures can be flexion or extension with or without joint subluxation and patella involvement. Options for management are serial casting, soft tissue release, growth modulation, bony surgery, gradual correction with fixator or a combination of these based on the severity and age at presentation. Pterygium management is difficult due to proximity of neurovascular structures to the skin web and higher risk of recurrence. Hip contractures and dislocation when unilateral should be treated surgically. Treatment of bilateral affection is controversial and should be individualised.
Keywords: Arthrogryposis, Amyoplasia, Arthrogryposis multiplex congenita, Hip contracture, Knee contracture, Lower limb deformity, Atypical clubfoot.

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How to Cite this Article: Shah IP, Ranmuthuge S, Parnami V, Chytas A | Lower Limb Deformity Management in Arthrogryposis – What to Correct and When | International Journal of Paediatric Orthopaedics | May-August 2024; 10(2): 40-47.
https://doi.org/10.13107/ijpo.2024.v10.i02.192

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