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9 years’ follow-up of 168 pin-fixed supracondylar humerus fractures in children

BACKGROUND AND PURPOSE: The long-term outcome of pin-fixed supracondylar humerus fractures (SCHF) in children is not well known. We assessed the 7- to 12-year outcome in 168 children. PATIENTS AND METHODS: During 2002–2006, 210 domestic children (age 7 (1–14) years) with SCHF (Gartland III 79%, Gart...

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Autores principales: Tuomilehto, Noora, Sommarhem, Antti, Nietosvaara, Aarno Y
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6055784/
https://www.ncbi.nlm.nih.gov/pubmed/29451050
http://dx.doi.org/10.1080/17453674.2018.1438765
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author Tuomilehto, Noora
Sommarhem, Antti
Nietosvaara, Aarno Y
author_facet Tuomilehto, Noora
Sommarhem, Antti
Nietosvaara, Aarno Y
author_sort Tuomilehto, Noora
collection PubMed
description BACKGROUND AND PURPOSE: The long-term outcome of pin-fixed supracondylar humerus fractures (SCHF) in children is not well known. We assessed the 7- to 12-year outcome in 168 children. PATIENTS AND METHODS: During 2002–2006, 210 domestic children (age 7 (1–14) years) with SCHF (Gartland III 79%, Gartland II 19%, and flexion type 2%) were pin fixed in Helsinki. 36 (17%) patients had a nerve palsy. Radiographic alignment was regarded as satisfactory in 81% of patients (Baumann angle (BA) within ±10˚ of normal range and whose anterior humeral line (AHL) crossed the capitulum). After a mean follow-up of 9 (7–12) years, 168 (80%) patients answered a questionnaire regarding elbow appearance (scale 0–10), function (scale 0–10), and pain (scale 0–10), and symmetry of range of motion (ROM) and carrying angle (CA). 65 (31%) patients also attended a clinical follow-up examination. RESULTS: Mean subjective score for appearance was 8.7 (2–10) and for function 9.0 (2–10) (n = 168). Elbow ROM asymmetry was experienced by 28% and elbow CA asymmetry by 17% of the patients. Elbow pain was reported by 14%, and was more common in children with nerve injuries. Long-term outcome was good or excellent in 60/65 and CA in 56/65 of the follow-up visit patients using Flynn’s criteria. BA exceeding normal values by 10˚ was associated with lower subjective outcome; AHL crossing point with the capitulum was not associated with outcome. INTERPRETATION: Long-term subjective outcome is satisfactory with few exceptions if elbow ROM and CA are restored within 10° of the uninjured elbow. Radiographs at fracture union have little prognostic value. Nerve injuries can cause long-term pain.
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spelling pubmed-60557842018-07-24 9 years’ follow-up of 168 pin-fixed supracondylar humerus fractures in children Tuomilehto, Noora Sommarhem, Antti Nietosvaara, Aarno Y Acta Orthop Shoulder and Children BACKGROUND AND PURPOSE: The long-term outcome of pin-fixed supracondylar humerus fractures (SCHF) in children is not well known. We assessed the 7- to 12-year outcome in 168 children. PATIENTS AND METHODS: During 2002–2006, 210 domestic children (age 7 (1–14) years) with SCHF (Gartland III 79%, Gartland II 19%, and flexion type 2%) were pin fixed in Helsinki. 36 (17%) patients had a nerve palsy. Radiographic alignment was regarded as satisfactory in 81% of patients (Baumann angle (BA) within ±10˚ of normal range and whose anterior humeral line (AHL) crossed the capitulum). After a mean follow-up of 9 (7–12) years, 168 (80%) patients answered a questionnaire regarding elbow appearance (scale 0–10), function (scale 0–10), and pain (scale 0–10), and symmetry of range of motion (ROM) and carrying angle (CA). 65 (31%) patients also attended a clinical follow-up examination. RESULTS: Mean subjective score for appearance was 8.7 (2–10) and for function 9.0 (2–10) (n = 168). Elbow ROM asymmetry was experienced by 28% and elbow CA asymmetry by 17% of the patients. Elbow pain was reported by 14%, and was more common in children with nerve injuries. Long-term outcome was good or excellent in 60/65 and CA in 56/65 of the follow-up visit patients using Flynn’s criteria. BA exceeding normal values by 10˚ was associated with lower subjective outcome; AHL crossing point with the capitulum was not associated with outcome. INTERPRETATION: Long-term subjective outcome is satisfactory with few exceptions if elbow ROM and CA are restored within 10° of the uninjured elbow. Radiographs at fracture union have little prognostic value. Nerve injuries can cause long-term pain. Taylor & Francis 2018-06 2018-02-16 /pmc/articles/PMC6055784/ /pubmed/29451050 http://dx.doi.org/10.1080/17453674.2018.1438765 Text en © The Author(s). Published by Taylor & Francis on behalf of the Nordic Orthopedic Federation. https://creativecommons.org/licenses/by/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution-Non-Commercial License (https://creativecommons.org/licenses/by/4.0)
spellingShingle Shoulder and Children
Tuomilehto, Noora
Sommarhem, Antti
Nietosvaara, Aarno Y
9 years’ follow-up of 168 pin-fixed supracondylar humerus fractures in children
title 9 years’ follow-up of 168 pin-fixed supracondylar humerus fractures in children
title_full 9 years’ follow-up of 168 pin-fixed supracondylar humerus fractures in children
title_fullStr 9 years’ follow-up of 168 pin-fixed supracondylar humerus fractures in children
title_full_unstemmed 9 years’ follow-up of 168 pin-fixed supracondylar humerus fractures in children
title_short 9 years’ follow-up of 168 pin-fixed supracondylar humerus fractures in children
title_sort 9 years’ follow-up of 168 pin-fixed supracondylar humerus fractures in children
topic Shoulder and Children
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6055784/
https://www.ncbi.nlm.nih.gov/pubmed/29451050
http://dx.doi.org/10.1080/17453674.2018.1438765
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