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One-Stage Emergency Surgical Release of Amniotic Constriction Band in Streeter’s Dysplasia with Clubfoot- A Case Report

Volume 8 | Issue 1 | January-April 2022 | Page: 43-46 | Harsharan Singh Oberoi, Baldish Singh Oberoi DOI-10.13107/ijpo.2022.v08i01.133 Authors: Harsharan Singh Oberoi MS, DNB Ortho [1], Baldish Singh Oberoi MS Ortho, MPH [1] [1] Department of Orthopaedics, Oberoi Hospital, Jalandhar City, Punjab, India. Address of Correspondence Dr. Baldish Singh Oberoi Orthopaedic Surgeon, Oberoi Hospital, Jalandhar City, […]

Fixation of Displaced Paediatric Humeral Lateral Condyle Fractures with 3 K-Wires

Volume 8 | Issue 1 | January-April 2022 | Page: 31-34 | Deepak Jain, Tushar Agrawal, Saijyot Raut, Parimal Malviya DOI-10.13107/ijpo.2022.v08i01.131 Authors: Deepak Jain MS Ortho [1], Tushar Agrawal MS Ortho [2, 3], Saijyot Raut MS Ortho [2], Parimal Malviya MS Ortho. [2] [1] Department of Orthopaedics & Spine Surgery Ganga Hospital, Coimbatore, Tamil Nadu, India. [2] […]

One-Stage Emergency Surgical Release of Amniotic Constriction Band in Streeter’s Dysplasia with Clubfoot- A Case Report

Fixation of Displaced Paediatric Humeral Lateral Condyle Fractures with 3 K-Wires

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One-Stage Emergency Surgical Release of Amniotic Constriction Band in Streeter’s Dysplasia with Clubfoot- A Case Report

Volume 8 | Issue 1 | January-April 2022 | Page: 43-46 | Harsharan Singh Oberoi, Baldish Singh Oberoi

DOI-10.13107/ijpo.2022.v08i01.133

Authors: Harsharan Singh Oberoi MS, DNB Ortho [1], Baldish Singh Oberoi MS Ortho, MPH [1]

[1] Department of Orthopaedics, Oberoi Hospital, Jalandhar City, Punjab, India.

Address of Correspondence

Dr. Baldish Singh Oberoi
Orthopaedic Surgeon, Oberoi Hospital, Jalandhar City, Punjab, India.
Email: baldishoberoi@gmail.com

Abstract

Streeter’s dysplasia is a rare condition that occurs in 1 in 1200 to 1 in 15000 live births. Timely intervention is the key in saving the limb in vascular compromised cases. A 7 days old neonate presented with Streeter’s Dysplasia with a grossly swollen, deformed and cyanosed foot. The deformity was a clubfoot deformity. There was a circumferential amniotic constriction band in the lower third left leg, causing a vascular compromise leading to bluish discoloration and gross swelling of the foot and toes. There was another semicircular band in the mid-foot region. One stage urgent circumferential band excision and multiple Z plasties for skin cover were done. The foot and the toes turned pink immediately. The swollen foot was treated by debulking of the foot and the clubfoot deformity by the Ponseti method.
Keywords: Streeter’s dysplasia, Vascular compromise, Constriction ring, One stage release, Clubfoot, Debulking

References

1. Quintero RA, Morales WJ, Phillips J, Kalter CS, Angel JL. In utero lysis of amniotic bands. Ultrasound Obstet Gynecol. 1997 Nov;10(5):316-20.
2. Patterson TJ. Congenital ring-constrictions. Br J Plast Surg. 1961 Apr;14:1-31.
3. Tada K, Yonenobu K, Swanson AB. Congenital constriction band syndrome. J Pediatr Orthop. 1984 Nov;4(6):726-30.
4. Baker CJ, Rudolph AJ. Congenital ring constrictions and intrauterine amputations. Am J Dis Child. 1971 May;121(5):393-400.
5. Naqvi ZG, Rao I, Anwer W, Yaseen T. Two-stage release in Streeter’s dysplasia. BMJ Case Rep. 2015 Apr 21;2015:bcr2014207568.
6. Chiu DTW, Patel A, Sakamoto S, Chu A. The Impact of Microsurgery on Congenital Hand Anomalies Associated with Amniotic Band Syndrome. Plast Reconstr Surg Glob Open. 2018 Apr 4;6(4):e1657.
7. Streeter GL. Focal deficiencies in fetal tissues and their relation to intrauterine amputations. Contrib. Embryol. 1930;22:1-44.
8. Torpin R. Amniochorionic mesoblastic fibrous strings and amnionic bands: associated constricting fetal malformations or fetal death. Am J Obstet Gynecol. 1965 Jan 1;91:65-75.
9. Hata T, Tanaka H, Noguchi J. 3D/4D sonographic evaluation of amniotic band syndrome in early pregnancy: a supplement to 2D ultrasound. J Obstet Gynaecol Res. 2011 Jun;37(6):656-60.
10. Pedersen TK, Thomsen SG. Spontaneous resolution of amniotic bands. Ultrasound Obstet Gynecol. 2001 Dec;18(6):673-4.
11. Alabdrabalnabi FI, Elsaid AS, Alsinan FM, Almushrif HA, Nasr MA, Elashaal E, Aljehani RK. Early release of constricting amniotic band of the lower limb followed by reconstruction using multiple Z-plasty. J Pediatr Surg. Case Rep. 2021 Dec 1;75:102054.
12. Dufournier B, Guero S, de Tienda M, Dana C, Garcelon N, Glorion C, Salon A, Pannier S. One-stage circumferential limb ring constriction release and direct circular skin closure in amniotic band syndrome: a 14-case series. Orthop Traumatol Surg Res. 2020 Nov;106(7):1353-9.
13. Carpiaux AM, Hosseinzadeh P, Muchow RD, Iwinski HJ, Walker JL, Milbrandt TA. The Effectiveness of the Ponseti Method for Treating Clubfoot Associated With Amniotic Band Syndrome. J Pediatr Orthop. 2016 Apr-May;36(3):284-8.
14. Basheer SM, Karashi AR, Abdulbasith M. Single stage release of bilateral amniotic band syndrome. Bahrain Med.Bull. 2019 Mar 1;41(1):38-41.
15. Waiswa G, Nassaazi J, Kajja I. Single stage release surgery for congenital constriction band in a clubfoot patient managed at a Teaching Hospital In Uganda: A case report. East Afr. Orthop J. 2020 Nov 12;14(2):99-101.

How to Cite this Article: Oberoi HS, Oberoi BS| One-Stage Emergency Surgical Release of Amniotic Constriction Band in Streeter’s Dysplasia with Clubfoot- A Case Report | International Journal of Paediatric Orthopaedics | January-April 2022; 8(1): 43-46.

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Fixation of Displaced Paediatric Humeral Lateral Condyle Fractures with 3 K-Wires

Volume 8 | Issue 1 | January-April 2022 | Page: 31-34 | Deepak Jain, Tushar Agrawal, Saijyot Raut, Parimal Malviya

DOI-10.13107/ijpo.2022.v08i01.131

Authors: Deepak Jain MS Ortho [1], Tushar Agrawal MS Ortho [2, 3], Saijyot Raut MS Ortho [2],
Parimal Malviya MS Ortho. [2]

[1] Department of Orthopaedics & Spine Surgery Ganga Hospital, Coimbatore, Tamil Nadu, India.
[2] Department of Orthopaedics, MGM Hospital, Navi Mumbai, Maharashtra, India.
[3] Aastha Hospital, Mumbai, Maharashtra, India.

Address of Correspondence
Dr. Deepak Jain,
Paediatric Orthopaedic Fellow, Department of Orthopaedics & Spine Surgery, Ganga Hospital, Coimbatore, Tamil Nadu, India.
E-mail: deepaksjain1993@gmail.com

Abstract

Background- Management of paediatric humeral lateral condyle fractures by 2 Kirschner wire or screw fixation in parallel or divergent manner remains the treatment of choice and has long remained unchallenged. In this study, we are recommending using a third K wire for fracture fixation technique for the age group less than 10 years which provides a more stable fixation enhances stability and ensures better outcomes without any significant disadvantages.
Materials & Methods- We Present a Cohort of 20 pediatric lateral condyle fractures of Song et al stage 3 and above. Of the 20 patients treated, 12 were male and 8 females. All fractures were fixed using 3 lateral Kirschner wires of size 1.2 or 1.5mm. Out of the 20 fractures, 12 were opened and 8 were fixed percutaneously.
Results- All Patients showed union at 6 weeks. K-wires were removed at 6 weeks. Good radiological and clinical outcomes were noted on the periodical check-up. Hardacre score was used to calculate clinical outcome. None of the patients had any loss of reduction, non-union, or implant-related failure except for pin tract infections in a few patients.
Conclusion- We recommend adding a third wire to the construct for three k wires fixation for lateral condyle humerus fractures in all patients less than 10 years which is useful tool, cost-effective, enhances stability and ensures good outcomes without any significant disadvantages. We found all benefits of the cannulated screws by inserting the third wire and the fracture was found to be biomechanically more stable, none showed loss of reduction, had early union, early mobilization, minimal chances of nonunion, full ROM, no infection with the added advantage of no re-surgery for implant removal
Keywords- Pediatric fractures, Elbow fractures, Lateral condyle fractures, K-wires

References

1. Beaty JH, Kasser JR. The elbow: Physeal fractures, apophyseal injuries of the distal humerus, osteonecrosis of the trochlea, and T¬-condylar fractures. In: Beaty JH, Kasser JR, eds. Rockwood and Wilkins’ Fractures in Children. Philadelphia, PA: Lippincott Williams & Wilkins; 2006:591–660

2. Song KS, Kang CH, Min BW, et al. Closed reduction and internal fixation of displaced unstable lateral condylar fractures of the humerus in children. J Bone Joint Surg Am. 2008;90: 2673–2681.

3. Mintzer CM, Waters PM, Brown DJ, Kasser JR. Percutaneous pinning in the treatment of displaced lateral condyle fractures. J Pediatr Orthop 1994; 14:462–465

4. Song KS, Shin YW, Oh CW, et al. Closed reduction and internal fixation of completely displaced and rotated lateral condyle.

5. Nishikant K, Anil M, Chandrashekhar Y, Rishi R, Sanjay M, Nilesh B. Delayed presentation of fracture of lateral condyle of humerus in pediatric age group treated by ORIF and ulnar peg grafting: a case series. J Orthop Allied Sci 2015; 3:12–16.

6. Foster DE, Sullivan JA, Gross RH. Lateral humeral condylar fractures in children. J Pediatr Orthop 1985; 5:16–22.

7. Thomas DP, Howard AW, Cole WG, Hedden DM. Three weeks of Kirschner wire fixation for displaced lateral condylar fractures of the humerus in children. J Pediatr Orthop 2001; 21:565–569.

8. Song KS, Chul K, Byung M, Ki B, Chul C, Ju L. Closed reduction and internal fixation of displaced unstable lateral condylar fractures of the humerus in children. J Bone Joint Surg Am 2008; 90:2673–2681.

9. Audrey V, Tercier S, Vauclair F, Bregou¬ Bourgeois A, Lutz N, Zambelli PY. Lateral condyle fracture of the humerus in children treated with bioabsorbable materials. Sci World J. 2013;2013:869418. doi:10.1155/2013/869418.

10. Mintzer CM, Waters PM, Brown DJ, Kasser JR. Percutaneous pinning in the treatment of displaced lateral condyle fractures. J Pediatr Orthop. 1994;14(4):462–465. doi:10.1097/01241398¬ 199407000¬00008.

11. Song KS, Kang CH, Min BW, Bae KC, Cho CH, Lee JH. Closed reduction and internal fixation of displaced unstable lateral condylar fractures of the humerus in children. J Bone Joint Surg Am. 2008;90 (12):2673–2681. doi:10.2106/JBJS.G.01227.

12. Marcheix PS, Vacquerie V, Longis B, Peyrou P, Fourcade L, Moulies D. Distal humerus lateral condyle fracture in children: when is the conservative treatment a valid option? Orthop Traumatol.

13. Weiss JM, Graves S, Yang S, Mendlesohn E, Kay RM, Skaggs DL (2009): A new classification system predictive of complications in surgically treated pediatric humeral lateral condyle fractures. J Pediatr Orthop., 29:602– 605.

14. Leonidou A, Chettiar K, Graham S, Akhbari P, Antonis K, Tsiridis E, Leonidou O (2014): Open reduction internal fixation of lateral humeral condyle fractures in children. A series of 105 fractures from a single institution. Strategies Trauma Limb Reconstr., 9:73–78.

15. Hardacre JA, Nahigian SH, Froimson AI, Brown JE (1971) Fractures of the lateral condyle of the humerus in children. J Bone Joint Surg Am 53(6):1083–1095.

16. R. Lal Sahu Percutaneous K wire fixation in pediatric lateral condylar fractures of humerus: A prospective study. Rev Esp Cir Ortop Traumatol. 2017

17. R. Ganeshalingam, A. Donnan, O. Evans, M. Hoq, M. Camp, L. Donnan Lateral condylar fractures of the humerus in children DOES THE TYPE OF FIXATION MATTER? Bone Joint J 2018;100¬B:387–95.

18. Gilbert SR, MacLennan PA, Schlitz RS, Estes AR. Screw versus pin fixation with open reduction of pediatric lateral condyle fractures. J Pediatr Orthop B 2016;25:148– 152.

19. Li WC, Xu RJ. Comparison of Kirschner wires and AO cannulated screw internal fixation for displaced lateral humeral condyle fracture in children. Int Orthop 2012;36:1261–1266.

20. Sharma JC, Arora A, Mathur NC, et al. Lateral condyle fractures of the humerus in children: fixation with partially threaded 4.0¬mm AO cancellous screws. J Trauma. 1995;39:1129–1133.

21. Baharuddin M, Sharaf I. Screw osteosynthesis in the treatment of fracture. Med J Malaysia. 2001;56(suppl D):45–47.

22. Conner AN, Smith MGH: Displaced Fractures of the lateral Humeral Condyle in Children. J Bone Joint Surg 52B:460,1970.

23. Saraf SK, Khare GN (2011) Late presentation of fractures of the lateral condyle of the humerus in children. Indian J Orthop 45 (1):39–44.

24. Danielle S. Wendling¬Keim1 Sandra Teschemacher1 Hans¬ Georg Dietz1 Markus Lehner Lateral Condyle Fracture of the Humerus in Children: Kirschner Wire or Screw Fixation? European Journal of Pediatric Surgery 2020.

25. Ya¬ Fei Qin, MD, Zhi¬ Jun Li, MD, Cheng¬ Kai Li, MD, Shu ¬Cai Bai, MD, Hui Li, MD Unburied versus buried wires for fixation of pediatric lateral condyle distal humeral fractures A meta-analysis Qin et al. Medicine (2017) 96:34.

26. Avijeet Prasad, Puneet Mishra, Aditya N Aggarwal, Manish Chadha, Rohit Pandey, Rahul Anshuman Exposed versus Buried Kirschner Wires Used in Displaced Pediatric Fractures of Lateral Condyle of Humerus. Indian Journal of Orthopaedics | Volume 52| Issue 5 | September¬-October 2018

How to Cite this Article: Jain D, Agrawal T, Raut SJ, Malviya P | Fixation of Displaced Paediatric Humeral Lateral Condyle Fractures with 3 K-Wires | International Journal of Paediatric Orthopaedics | January-April 2022; 8(1): 31-34.

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Half Sized Blog Element (Multi Author Style)

One-Stage Emergency Surgical Release of Amniotic Constriction Band in Streeter’s Dysplasia with Clubfoot- A Case Report

Fixation of Displaced Paediatric Humeral Lateral Condyle Fractures with 3 K-Wires

One-Stage Emergency Surgical Release of Amniotic Constriction Band in Streeter’s Dysplasia with Clubfoot- A Case Report

Fixation of Displaced Paediatric Humeral Lateral Condyle Fractures with 3 K-Wires

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One-Stage Emergency Surgical Release of Amniotic Constriction Band in Streeter’s Dysplasia with Clubfoot- A Case Report

Authors: Harsharan Singh Oberoi MS, DNB Ortho [1], Baldish Singh Oberoi MS Ortho, MPH [1]

Abstract

(Article Text HTML) (Full Text PDF)

Fixation of Displaced Paediatric Humeral Lateral Condyle Fractures with 3 K-Wires

Authors: Deepak Jain MS Ortho [1], Tushar Agrawal MS Ortho [2, 3], Saijyot Raut MS Ortho [2],
Parimal Malviya MS Ortho. [2]

Abstract

(Article Text HTML) (Full Text PDF)

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