Ipsilateral Supracondylar Humerus Fracture with Distal End Radius Fracture in Children: A Series of 10 Cases
Volume 3 | Issue 1 | Jan-Jun 2017 | Page 6-8 | Chirag Borana, Naeem Jagani, Nadir Shah, Lokesh Sharoff, Sunirmal Mukherjee
Authors : Chirag Borana [1], Naeem Jagani [2], Nadir Shah [3], Lokesh Sharoff [4], Sunirmal Mukherjee [5].
[1,2,4] Consultant, Dept of Orthopaedics, Masina Hospital, Byculla, Mumbai.
[3] Asst. Professor, Dept of Orthopaedics, Sir JJ Group of Hospitals, Mumbai.
[5] Senior Resident, Dept of Orthopaedics, Sir JJ Group of Hospitals, Mumbai.
Address of Correspondence
Dr. Lokesh Sharoff,
42, Madhur Milan Society,14th B Road, Khar West, Mumbai 400052.
Email: drlokeshsharoff@outlook.com
Abstract
Background: Supracondylar humerus fracture with forearm fractures are rare with reported incidence ranging from 3% to 13%.
Materials and Methods: We have treated 10patients with ipsilateral supracondylar humerus fracture with distal radius fracture. One had a Gustilo-Anderson Grade 2 open supracondylar humerus fracture. All displaced fractures were treated with K-wire fixation by aclosed method except the open fracture which warranted wound debridement and subsequent open reduction. A follow-up of at least 6 months is available for all our patients.
Results: All fractures showed signs of union by 6 weeks when K-wires were removed. At6 months, 9 patients had excellent outcome while one patient with recovering radial nerve palsy had afair outcome. No cases of non-union or loss of reduction were seen in the post-operative period. Pin tract site infection was seen in one patient with anopen fracture which resolved after K-wire removal and antibiotic coverage.
Conclusion and Learning: This study recommends screening radiographs of forearm and wrist in patients with supracondylar humerus fractures to rule out any associated forearm/wrist injury. We also recommend closed reduction and K-wire fixation of the displaced supracondylar humerus as well as distal radius fractures.
Keywords: Pediatric fractures; Double fractures; Adolescent fractures; Immature skeletal fractures; upper-extremity fractures.
References
1. McLauchlan GJ, Walker CR, Cowan B, Robb JE, Prescott RJ. Extension of the elbow and supracondylar fractures in children. J Bone Joint Surg Br 1999;81(3):402-405.
2. Dhoju D, Shrestha D, Parajuli N, Dhakal G, Shrestha R. Ipsilateral supracondylar fracture and forearm bone injury in children: A retrospective review of thirty one cases. Kathmandu Univ Med J (KUMJ) 2011;9(34):11-16.
3. Siemers F, Obertacke U, Fernandez ED, Olivier LC, Neudeck F. Combination of ipsilateral supracondylar humeral-and forearm fractures in children. ZentralblChir 2002;127(3):212-217.
4. Tabak AY, Celebi L, Muratli HH, Yagmurlu MF, Aktekin CN, Biçimoglu A. Closed reduction and percutaneous fixation of supracondylar fracture of the homers and ipsilateral fracture of the forearm in children. J Bone Joint Surg Br 2003;85(8):1169-11672.
5. Powell RS, Bowe JA. Ipsilateral supracondylar homers fracture and Monteggia lesion: A case report. J Orthop Trauma 2002;16(10):737-740.
6. Rouhani AR, Navali AM, Sadegpoor AR, Soleimanpoor J, Ansari M. Monteggia lesion and ipsilateral humeral supracondylar and distal radial fractures in a young girl. Saudi Med J 2007;28(7):1127-1128.
7. Cobanoglu M, Savk SO, Cullu E, Duygun F. Ipsilateral supracondylar homers fracture and Monteggia lesion with a 5-year follow-up: A rare injury in a young girl. BMJ Case Rep 2015;2015. pii: Bcr2014206313.
8. Peters CL, Scott SM, Stevens PM. Closed reduction and percutaneous pinning of displaced supracondylar homers fractures in children: Description of a new closed reduction technique for fractures with brachialis muscle entrapment. J Orthop Trauma 1995;9(5):430-434.
9. Biyani A, Gupta SP, Sharma JC. Ipsilateral supracondylar fracture of homers and forearm bones in children. Injury 1989;20(4):203-207.
10. Flynn JC, Matthews JG, Benoit RL. Blind pinning of displaced supracondylar fractures of the homers in children. Sixteen years’ experience with long-term follow-up. J Bone Joint Surg Am 1974;56(2):263-272.
11. Templeton PA, Graham HK. The ‘floating elbow’ in children. Simultaneous supracondylar fractures of the homers and of the forearm in the same upper limb. J Bone Joint Surg Br 1995;77(5):791-796.
| How to Cite this Article: Borana C, Jagani N, Shah N, Sharoff L, Mukherjee S. Osteochondroma Arising from the Head of the Fibula: A Rare Cause of Drop Foot in Pediatric Age. International Journal of Paediatric Orthopaedics Jan-June 2017;3(1):6-8. |
