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

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Tuomilehto , N , Sommarhem , A & Nietosvaara , A Y 2018 , ' 9 years' follow-up of 168 pin-fixed supracondylar humerus fractures in children ' , Acta Orthopaedica , vol. 89 , no. 3 , pp. 351-356 . https://doi.org/10.1080/17453674.2018.1438765

Title: 9 years' follow-up of 168 pin-fixed supracondylar humerus fractures in children
Author: Tuomilehto, Noora; Sommarhem, Antti; Nietosvaara, Aarno Y.
Other contributor: University of Helsinki, Clinicum
University of Helsinki, Clinicum
University of Helsinki, Lastenkirurgian yksikkö







Date: 2018
Language: eng
Number of pages: 6
Belongs to series: Acta Orthopaedica
ISSN: 1745-3674
DOI: https://doi.org/10.1080/17453674.2018.1438765
URI: http://hdl.handle.net/10138/235309
Abstract: 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 degrees of the uninjured elbow. Radiographs at fracture union have little prognostic value. Nerve injuries can cause long-term pain.
Subject: NERVE INJURIES
NEUROVASCULAR COMPLICATIONS
ANGLE
3126 Surgery, anesthesiology, intensive care, radiology
3123 Gynaecology and paediatrics
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