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Retrospective Mid-Term Follow-Up of Posttraumatic and Iatrogenic Neurovascular Complications in Surgically Treated Paediatric Patients with Distal Humerus Fracture

Background: The purpose of the study was to investigate and describe neurovascular complications and mid-term clinical outcomes of operatively managed fractures of the distal humerus in a paediatric population. Neurovascular injuries are common in these fractures, but reports about their implication...

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Autores principales: Gutwerk, Alexander, Behrendt, Peter, Vetter, Svenja, Menzdorf, Leif, Oates, Edward, Jazra, Sebastian, Lippross, Sebastian, Klüter, Tim, Seekamp, Andreas, Weuster, Matthias
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9497747/
https://www.ncbi.nlm.nih.gov/pubmed/36138658
http://dx.doi.org/10.3390/children9091349
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author Gutwerk, Alexander
Behrendt, Peter
Vetter, Svenja
Menzdorf, Leif
Oates, Edward
Jazra, Sebastian
Lippross, Sebastian
Klüter, Tim
Seekamp, Andreas
Weuster, Matthias
author_facet Gutwerk, Alexander
Behrendt, Peter
Vetter, Svenja
Menzdorf, Leif
Oates, Edward
Jazra, Sebastian
Lippross, Sebastian
Klüter, Tim
Seekamp, Andreas
Weuster, Matthias
author_sort Gutwerk, Alexander
collection PubMed
description Background: The purpose of the study was to investigate and describe neurovascular complications and mid-term clinical outcomes of operatively managed fractures of the distal humerus in a paediatric population. Neurovascular injuries are common in these fractures, but reports about their implications for mid-term clinical outcomes is sparse. Methods: A single-centre retrospective study was conducted at a university teaching hospital investigating paediatric patients who underwent operative management of a distal humerus fracture between 2014 and 2018. Patient demographics, fracture classification, pre-, peri- and postoperative neurovascular complications were investigated. Mid-term follow up clinical examination and functional scoring using QuickDASH, the Broberg and Morrey Score (BMS), the Mayo Elbow Performance Score (MEPS) and the Numeric Rating Scale were performed. Results: A total of 84 patients were identified, of which 34 met the inclusion criteria and were available for follow-up clinical examination. The average time to follow-up was 150 weeks (1049.44 days ± 448.54). Ten primary traumatic neurovascular complications were identified, the majority of which involved the median nerve. Primary traumatic dissection of the brachial artery was recorded in three patients. Secondary iatrogenic nerve injury was documented in five patients after previously normal clinical examination. At follow-up, the average QuickDASH score was 3.0 ± 4.3, BMS was 98.6 ± 3.4 and MEPS was 97.1 ± 3.3 points. Conclusions: The mid-term clinical outcome following surgical management of distal humerus fractures is excellent. There is, however, a considerable frequency of both primary and secondary neurovascular complications, which must be considered when opting to treat these injuries surgically.
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spelling pubmed-94977472022-09-23 Retrospective Mid-Term Follow-Up of Posttraumatic and Iatrogenic Neurovascular Complications in Surgically Treated Paediatric Patients with Distal Humerus Fracture Gutwerk, Alexander Behrendt, Peter Vetter, Svenja Menzdorf, Leif Oates, Edward Jazra, Sebastian Lippross, Sebastian Klüter, Tim Seekamp, Andreas Weuster, Matthias Children (Basel) Article Background: The purpose of the study was to investigate and describe neurovascular complications and mid-term clinical outcomes of operatively managed fractures of the distal humerus in a paediatric population. Neurovascular injuries are common in these fractures, but reports about their implications for mid-term clinical outcomes is sparse. Methods: A single-centre retrospective study was conducted at a university teaching hospital investigating paediatric patients who underwent operative management of a distal humerus fracture between 2014 and 2018. Patient demographics, fracture classification, pre-, peri- and postoperative neurovascular complications were investigated. Mid-term follow up clinical examination and functional scoring using QuickDASH, the Broberg and Morrey Score (BMS), the Mayo Elbow Performance Score (MEPS) and the Numeric Rating Scale were performed. Results: A total of 84 patients were identified, of which 34 met the inclusion criteria and were available for follow-up clinical examination. The average time to follow-up was 150 weeks (1049.44 days ± 448.54). Ten primary traumatic neurovascular complications were identified, the majority of which involved the median nerve. Primary traumatic dissection of the brachial artery was recorded in three patients. Secondary iatrogenic nerve injury was documented in five patients after previously normal clinical examination. At follow-up, the average QuickDASH score was 3.0 ± 4.3, BMS was 98.6 ± 3.4 and MEPS was 97.1 ± 3.3 points. Conclusions: The mid-term clinical outcome following surgical management of distal humerus fractures is excellent. There is, however, a considerable frequency of both primary and secondary neurovascular complications, which must be considered when opting to treat these injuries surgically. MDPI 2022-09-04 /pmc/articles/PMC9497747/ /pubmed/36138658 http://dx.doi.org/10.3390/children9091349 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Gutwerk, Alexander
Behrendt, Peter
Vetter, Svenja
Menzdorf, Leif
Oates, Edward
Jazra, Sebastian
Lippross, Sebastian
Klüter, Tim
Seekamp, Andreas
Weuster, Matthias
Retrospective Mid-Term Follow-Up of Posttraumatic and Iatrogenic Neurovascular Complications in Surgically Treated Paediatric Patients with Distal Humerus Fracture
title Retrospective Mid-Term Follow-Up of Posttraumatic and Iatrogenic Neurovascular Complications in Surgically Treated Paediatric Patients with Distal Humerus Fracture
title_full Retrospective Mid-Term Follow-Up of Posttraumatic and Iatrogenic Neurovascular Complications in Surgically Treated Paediatric Patients with Distal Humerus Fracture
title_fullStr Retrospective Mid-Term Follow-Up of Posttraumatic and Iatrogenic Neurovascular Complications in Surgically Treated Paediatric Patients with Distal Humerus Fracture
title_full_unstemmed Retrospective Mid-Term Follow-Up of Posttraumatic and Iatrogenic Neurovascular Complications in Surgically Treated Paediatric Patients with Distal Humerus Fracture
title_short Retrospective Mid-Term Follow-Up of Posttraumatic and Iatrogenic Neurovascular Complications in Surgically Treated Paediatric Patients with Distal Humerus Fracture
title_sort retrospective mid-term follow-up of posttraumatic and iatrogenic neurovascular complications in surgically treated paediatric patients with distal humerus fracture
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9497747/
https://www.ncbi.nlm.nih.gov/pubmed/36138658
http://dx.doi.org/10.3390/children9091349
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