Tag Archive for: Children

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

Volume 9 | Issue 1 | January-April 2023 | Page: 01-06 | Shane Moe, Hein Latt Win, Kyaw Kyaw, Wai Lin Tun, Ye Htut Aung

DOI- https://doi.org/10.13107/ijpo.2023.v09.i01.148

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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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
5. Birkett, N., Al-Tawil, K., & Montgomery, A. Functional outcomes following surgical fixation of paediatric lateral condyle fractures of the elbow – A systematic review. Orthopedic Research and Reviews, 2020; 12: 45-52.
https://doi.org/10.2147/ORR.S215742
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7. Weiss, J. M., Graves, S., Yang, S., Mendelsohn, E., Kay, R. M., & Skaggs, D. L. A new classification system predictive of complications in surgically treated pediatric humeral lateral condyle fractures. Journal of Paediatric Orthopaedics, 2009; 29(6): 602-605. https://doi.org/ 10.1097/bpo.0b013e3181b2842c
8. Aggarwal. N. D., Dhaliwal, R. S., Aggarwal, R. Management of the fractures of the lateral humeral condyle with special emphasis on neglected cases. Indian Journal of Orthopaedics, 1985; 19: 26-32.
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12. Sial, N. A., Iqbal, M. J., & Shaukat, M. K. Open reduction and k-wire fixation of displaced unstable lateral condyle fractures of the humerus in children. The Professional Medical Journal, 2011; 18(03): 501-509.
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.
14. Li, W. C., & Xu, R. J. Comparison of Kirschner wires and AO cannulated screw internal fixation for displaced lateral humeral condyle fracture in children. International orthopaedics, 2012; 36(6): 1261-1266. https://doi.org/ 10.1007/s00264-011-1452-y
15. Stevenson, R. A., & Perry, D. C. Paediatric lateral condyle fractures of the distal humerus. Orthopaedics and Trauma, 2018; 32(5): 352-359. https://doi.org/ 10.1016/j.mporth.2018.07.013
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
17. Schlitz, R. S., Schwertz, J. M., Eberhardt, A. W., & Gilbert, S. R. (2015). Biomechanical analysis of screws versus K-wires for lateral humeral condyle fractures. Journal of Pediatric Orthopaedics, 35(8), e93-e97. https://doi.org/ 10.1097/BPO.0000000000000450
18. Ganeshalingam, R., Donnan, A., Evans, O., Hoq, M., Camp, M., & Donnan, L. Lateral condylar fractures of the humerus in children: Does the type of fixation matter? The Bone & Joint Journal, 2018; 100(3): 387-395. https://doi.org/ 10.1302/0301-620X.100B3
19. Luo, X., Chen, X., & Wang, J. A retrospective comparative study of open reduction and cannulated screw fixation and Kirschner wire fixation in the treatment of fracture of lateral condyle of humerus in children. Research Square. 2021; 1-12
20. Sharma, H., Maheshwari, R., & Wilson, N. Lateral humeral condyle fractures in children: a comparative cohort study on screws versus K-wires. Orthopaedic Proceedings. 2006; 88-B: Supp-III, 434-434.
21. Pribaz, J. R., Bernthal, N. M., Wong, T. C., & Silva, M. Lateral spurring (overgrowth) after pediatric lateral condyle fractures. Journal of Pediatric Orthopaedics, 2012; 32(5): 456-460.

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): 01-06 | https://doi.org/10.13107/ijpo.2023.v09.i01.148

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Bimodal Presentation of Septic Shoulder as Shoulder Dislocation in Children

Volume 9 | Issue 2 | May-August 2023 | Page: 01-04 | Md. Rakibul Hassan, Qaisur Rabbi, Ayesha Hasina, Mehedi Hasan, Mahfoozur Rahman

DOI- https://doi.org/10.13107/ijpo.2023.v09.i02.154

Authors: Md. Rakibul Hassan D-Ortho, MRCS (UK) [1], Qaisur Rabbi D-Ortho [2], Ayesha Hasina FCPS (Paed), MD (Paed), MCPS (Paed) [3], Mehedi Hasan MRCS (UK) [4], Mahfoozur Rahman D-Ortho [5]

[1] Department of Orthopaedics, Trauma & Spine Surgery Unit, Sheikh Fazilatunnessa Mujib Memorial KPJ Specialized Hospital, Gazipur, Dhaka, Bangladesh.
[2] Department of Pediatric Orthopaedics, Centre of Rehabilitation for Paralyzed, Savar & Mirpur-14, Dhaka, Bangladesh.
[3] Department of Paediatric & Neonatology, Sheikh Fazilatunnessa Mujib Memorial KPJ Specialized Hospital, Gazipur, Dhaka, Bangladesh.
[4] Department of Orthopaedics, Ahsania Mission Cancer Hospital, Dhaka, Bangladesh.
[5] Department of Trauma & Paediatric Orthopaedics, Eastern Medical Collage & Hospital, Cumilla, Bangladesh.

Address of Correspondence

Dr. Md. Rakibul Hassan,
Consultant, Department of Orthopaedics, Trauma & Spine Surgery, Sheikh Fazilatunnessa Mujib Memorial KPJ Specialized Hospital, Gazipur, Dhaka, Bangladesh.
E-mail: rimon.rakibulhassan@gmail.com

 

Abstract

Introduction: The presence of a largely cartilaginous humeral head in children makes it difficult to diagnose septic arthritis of the shoulder.
Patients and methods: We conducted a case note review of five patients who presented with septic arthritis of shoulder joint.
Results: The age of the affected children ranged from 6 months to 10 years. Patients presented on average after 22 days from onset of symptoms. Staphylococcus aureus and Pseudomonas aeruginosa were obtained on pus culture. All cases were treated operatively by arthrotomy and drainage along with appropriate antibiotic administration for a period of 6 weeks.
Conclusion: Successful treatment of septic arthritis of the shoulder was achieved in all cases. At an average follow-up of 6 months, good outcome was noted with restoration of full range of shoulder movements.
Keywords: Septic shoulder, Children, Shoulder dislocation

References

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How to Cite this Article: Hassan MR, Rabbi Q, Hasina A, Hasan M, Rahman M | Bimodal Presentation of Septic Shoulder as Shoulder Dislocation in Children | International Journal of Paediatric Orthopaedics | May-August 2023; 9(2): 01-04 | https://doi.org/10.13107/ijpo.2023.v09.i02.154

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Frontal Plane Angular Knee Deformities in Schoolchildren in Kribi, South Region of Cameroon

Volume 9 | Issue 1 | January-April 2023 | Page: 13-20 | Jean Gustave Tsiagadigui, Robinson Mbako Ateh, Marie-Ange Ngo Yamben, Franck Olivier Ngongang, Daniel Handy Eone, Maurice Aurelien Sosso

DOI- https://doi.org/10.13107/ijpo.2023.v09.i01.150

Authors: Jean GustaveTsiagadigui [1, 3] MD, PhD, Robinson Mbako Ateh [2] MD, Marie-Ange Ngo Yamben [1] MD, Franck Olivier Ngongang [1] MD, Daniel Handy Eone [1] MD, Maurice Aurelien Sosso [1] MD

[1] Department of Surgery and Specialties of Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, BP 1364, Yaoundé, Cameroon
[2] Faculty of Medicine and Pharmaceutical Sciences of the University of Douala, BP 2701, Douala, Littoral Region, Cameroon.
[3] Department of Mechanical Engineering, ENSET, University of Douala, BP 2701, Douala, Littoral Region, Cameroon.

Address of Correspondence

Dr. Jean GustaveTsiagadigui,
Department of Surgery and Specialties of Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, BP 1364, Yaoundé, Cameroon.
E-mail: jtsiagad@gmail.com

Abstract

Bone problems such as angular deformities of the knee are common in children in Africa. The aim of this survey was to study epidemiologic aspects of frontal plane angular knee deformities in school children in Kribi. A total of 860 school children in Kribi aged 3 to 18 years were surveyed in a cross-sectional descriptive study from December 2019 to March 2020. Each child was examined. Intercodylar distances, intermalleolar distances and the tibiofemoral angles were assessed. The type of knee deformity in the frontal plane was determined from the children`s tibiofemoral angles and compared with reference values of normal children in the same age ranges. One hundred and fourty two (142, 16.5%) children surveyed presented with frontal plane knee deformities, with genu varum representing 68.0% (96 cases) of the deformities. The prevalence of these deformities in school children in Kribi varied significantly with age. We did not find any significant difference in the variation of these deformities with gender or ethnic groups. We identified some frontal plane angular knee deformities, including bilateral deformities being predominant 90.71% (127 cases). The mean body mass index was higher than those of normal children. 15.5% (22) of them presented with associated deformity in the sagital plane, dominated by bilateral genu recurvatum and 33.8% (48) of them presented with associated rotational knee deformities, dominated by bilateral medial rotation. Frontal plane knee angular deformities are common amongst school children in Kribi. Their prevalence is 16.51% (142 cases). This prevalence varies with ages. Sagittal plane and rotational plane deformities are equally present in children presenting with these deformities.
Keywords: Bone, Children, Deformities, Cameroon.

References

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[2] Gale Group. Knee deformities. Gale Encyclopedia of Medecine. The Gale Group; 2008.
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How to Cite this Article: Tsiagadigui JG, Ateh RM, Yamben MAN, Ngongang FO, Eone DH, Sosso MA | Frontal Plane Angular Knee Deformities in School Children in Kribi, South Region of Cameroon | International Journal of Paediatric Orthopaedics | January-April 2023; 9(1): 13-20 | https://doi.org/10.13107/ijpo.2023.v09.i01.150

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ABCD of Lateral Condyle Humerus Fracture in Children: Anatomy, Biomechanics, Classification and Diagnosis

Volume 7 | Issue 2 | May-August 2021 | Page: 24-29 | Taral V Nagda, Avi Shah, Dhwanil Tada

Authors: Taral V Nagda [1], Avi Shah [1], Dhwanil Tada [1]

[1] Department of Orthopaedics, SRCC NH Childrens Hospital, Mumbai, Maharashtra, India

Address of Correspondence
Dr. Taral Nagda,
Consultant Paediatric Orthopaedic Surgeon, SRCC NH Children’s Hospital, Mumbai, Maharashtra, India.
E-mail: taralnagda@gmail.com

Abstract

The lateral condyle fractures which form less than 20% of paediatric elbow fractures are seen at average 6 years age and have less severity of signs and symptoms which may lead to delayed diagnosis. Internal rotation view of X-ray of elbow is important in addition to standard AP and Lateral views. Jakob, Weiss and Song are commonly used classification systems in decision making.

Keywords: Lateral condyle fracture, Children, Classification, Anatomy, Diagnosis.

Further Reading

1. Abzug JM, Dua K, Kozin SH, Herman MJ. Current concepts in the treatment of lateral condyle fractures in children. JAAOS-Journal of the American Academy of Orthopaedic Surgeons. 2020 Jan 1;28(1):e9-19.
2. Baker M, Borland M. Range of elbow movement as a predictor of bony injury in children. Emergency Medicine Journal. 2011 Aug 1;28(8):666-9.
3. Finnbogason T, Karlsson G, Lindberg L, Mortensson W. Nondisplaced and minimally displaced fractures of the lateral humeral condyle in children: a prospective radiographic investigation of fracture stability. J Pediatr Orthop. 1995;15:422–5.
4. Flynn JC, Richards JF, Saltzman RI. Prevention and treatment of non-union of slightly displaced fractures of the lateral humeral condyle in children. An end-result study. J Bone Jt Surg Am.1975;57:1087–92.
5. Herman MJ, Boardman MJ, Hoover JR, Chafetz RS. Relationship of the anterior humeral line to the capitellar ossific nucleus: variability with age. JBJS. 2009 Sep 1;91(9):2188-93
6. Houshian S, Mehdi B, Larsen MS. The epidemiology of elbow fracture in children: analysis of 355 fractures, with special reference to supracondylar humerus fractures. J Orthop Sci. 2001;6:312–5. https ://doi.org/10.1007/s0077 61006 0312.
7. Jakob R, Fowles JV, Rang M, Kassab MT. Observations concerning fractures of the lateral humeral condyle in children. J Bone Jt Surg Br. 1975;57:430–6.
8. Landin LA, Danielsson LG. Elbow fractures in children. Anepidemiological analysis of 589 cases. Acta Orthop Scand. 1986;57:309–12.
9. Pressmar J, Weber B, Kalbitz M. Different classifications concerning fractures of the lateral humeral condyle in children. European Journal of Trauma and Emergency Surgery. 2020 Apr 23:1-7.
10. Ramo BA, Funk SS, Elliott ME, Jo CH. The Song classification is reliable and guides prognosis and treatment for pediatric lateral condyle fractures: an independent validation study with treatment algorithm. Journal of Pediatric Orthopaedics. 2020 Mar 1;40(3):e203-9.
11. Schroeder K, Gilbert S, Ellington M, Souder C, Yang S. Pediatric Lateral Humeral Condyle Fractures. JPOSNA. 2020 May 3;2(1).
12. 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. JBJS. 2008 Dec 1;90(12):2673-81.
13. Song KS, Kang CH, Min BW, Bae KC, Cho CH. Internal oblique radiographs for diagnosis of nondisplaced or minimally displaced lateral condylar fractures of the humerus in children. JBJS. 2007 Jan 1;89(1):58-63.
14. Song KS, Waters PM. Lateral condylar humerus fractures: which ones should we fix? Journal of Pediatric Orthopaedics. 2012 Jun 1;32:S5-9.
15. Tan SH, Dartnell J, Lim AK, Hui JH. Paediatric lateral condyle fractures: a systematic review. Archives of Orthopaedic and Trauma Surgery. 2018 Jun 1;138(6):809-17.
16. Tan SHS, Dartnell J, Lim AKS, Hui JH. Paediatric lateral condyle fractures: A systematic review. Arch Orthop Trauma Surg. 2018;138(6):809–17.
17. Weiss JM, Graves S, Yang S, Mendelsohn E, Kay RM, Skaggs DL. A new classification system predictive of complications in surgically treated pediatric humeral lateral condyle fractures. J Pediar Orthop. 2009 Sep 1;29(6):602-5.

 

 

How to Cite this Article:  Nagda TV, Shah A, Tada D | ABCD of Lateral Condyle Humerus Fracture in Children: Anatomy, Biomechanics, Classification and Diagnosis | International Journal of Paediatric
Orthopaedics | May-August 2021; 7(2): 24-29.

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Primary Subacute Osteomyelitis of Talus: An Unusual Presentation of a Limping Child

Volume 3 | Issue 1 | Jan-Jun 2017 | Page 24-25 | Rajib Naskar, Balgovind S. Raja, Dhanish V. Mehendiratta, Pravin Jadhav, Harshad G. Argekar

Authors : Rajib Naskar [1], Balgovind S. Raja [2], Dhanish V. Mehendiratta [1], Pravin Jadhav [1], Harshad G. Argekar [1].

[1] Department of Orthopaedics, LTMC &Sion Hospital, Sion, Mumbai, Maharashtra, India,
[2] Department of Orthopaedics, K B Bhabha Municipal Hospital, Bandra, Mumbai, Maharashtra, India.

Address of Correspondence
Dr. Rajib Naskar,
Suite no.115, College building, Sion hospital, Dr. Ambedkar Road Mumbai 400022
Email: dr.rajibnaskar@gmail.com

Abstract

A 9-year-old female presented with symptoms of limp and pain in the right ankle region along with swelling. Prominent systemic features of osteomyelitis were lacking. The delay in diagnosis from limping to diagnosis confirmation and hospital admission was 6 days. The final diagnosiswas made after adetailed radiological investigation and open sampling and curettage. It was the treated conservatively, and after 6 weeks of treatment, radiological improvement was noted. We conclude that, in a limping child with ankle pain, subacute osteomyelitis of talus should be kept in mind as a differential and it can be successfully treated in outpatient basis with conservative management.
Keywords: Osteomyelitis, Talus, Children, Ankle pain.

References 

1. Lew DP, Waldvogel FA. Osteomyelitis. Lancet 2004;364(9431):369-379.
2. Krogstad P. Osteomyelitis. In: Feigin RD, Cherry JD, Demmler-Harrison GD, Kaplan SL, editors. Textbook of Pediatric Infectious Diseases. 6th ed. Philadelphia, PA, USA: Saunders Elsevier; 2009. p. 725-742

How to Cite this Article: Naskar R, Raja B S, Mehendiratta D V, Jadhav P, Argekar H G. Primary Subacute Osteomyelitis of Talus: An Unusual Presentation of a Limping Child. International Journal of Paediatric Orthopaedics Jan-Jun 2017;3(1):24-25.

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