SpringerLink
Log in

Repositie van supracondylaire humerusfracturen middels een tijdelijke Kirschner-draad

  • casus
  • Published:
Nederlands Tijdschrift voor Traumachirurgie

Samenvatting

Instabiele gedislokeerde supracondylaire humerusfracturen bij kinderen worden in opzet behandeld met gesloten repositie en fixatie middels Kirschner-draden. Het functionele resultaat is mede afhankelijk van een adequate repositie. Deze repositie kan met de conventionele repositiemethode lastig zijn bij deze soms multidirectioneel instabiele fracturen bij jonge kinderen. Het artikel beschrijft, aan de hand van een casus, een methode waarbij gebruik wordt gemaakt van een tijdelijke Kirschner-draad in het proximale humerusfragment. Zodra, middels manipulatie, de adequate repositie is bereikt, wordt de fractuur op de gebruikelijke manier gefixeerd en de tijdelijke Kirschner-draad verwijderd.

Deze techniek zou kunnen bijdragen aan het verkleinen van het aantal conversies naar een open repositie.

Abstract

Closed reduction and percutaneous pinning have become the standard method of treatment of displaced supracondylar humeral fractures in children. Precise anatomical reduction is crucial in order to get good treatment results. Traditional closed reduction can be challenging for these multidirectional, unstable fractures. Our goal is to point out a closed reduction method for the treatment of displaced supracondylar humeral fractures using a temporal Kirschner-wire which is positioned in the proximal humeral fragment. This technique could reduce the amount of conversions to open reposition.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (Germany)

Instant access to the full article PDF.

Institutional subscriptions

Figuur 1.
Figuur 2.
Figuur 3.
Figuur 4.
Figuur 5.

Literatuur

  1. Cheng J, Ng B, Ying S, Lam P. A 10-year study of the changes in the pattern and treatment of 6,493 fractures. J Pediatr Orthop. 1999. p. 344–50.

  2. Farnsworth C, Silva PD, Mubarak SJ. Etiology of supracondylar humerus fractures. J Pediatr Orthop. 1998 Jan-Feb;18(1):38–42.

    CAS  PubMed  Google Scholar 

  3. Gartland JJ. Management of supracondylar fractures of the humerus in children. Surg Gynecol Obstet. 1959 Aug;109(2):145–54.

    CAS  PubMed  Google Scholar 

  4. Tomaszewski R, Gap A, Wozowicz A, Wysocka P. Analysis of early vascular and neurological complications of supracondylar humerus fractures in children. Polish Orthop Traumatol. 2012;77:101–4.

    Google Scholar 

  5. Vincelet Y, Journeau P, Popkov D, et al. The anatomical basis for anterior interosseous nerve palsy secondary to supracondylar humerus fractures in children. Orthop Traumatol Surg Res. 2013 Sep;99(5):543–7.

    Article  CAS  PubMed  Google Scholar 

  6. Ramachandran M, Birch R, Eastwood DM. Clinical outcome of nerve injuries associated with supracondylar fractures of the humerus in children: the experience of a specialist referral centre. J Bone Joint Surg Br. 2006 Jan;88(1):90–4.

    Article  CAS  PubMed  Google Scholar 

  7. Ozkoc G, Gonc U, Kayaalp A, et al. Displaced supracondylar humeral fractures in children: open reduction vs. closed reduction and pinning. Arch Orthop Trauma Surg. 2004 Oct;124(8):547–51.

    Article  PubMed  Google Scholar 

  8. Brauer CA, Lee BM, Bae DS, et al. A systematic review of medial and lateral entry pinning versus lateral entry pinning for supracondylar fractures of the humerus. 2007;27(2):181–6.

  9. Pretell-Mazzini J, Rodriguez-Martin J, Andres-Esteban EM. Does open reduction and pinning affect outcome in severely displaced supracondylar humeral fractures in children? A systematic review. Strategies Trauma Limb Reconstr. 2010 Aug;5(2):57–64.

    Article  PubMed Central  PubMed  Google Scholar 

  10. Aktekin CN, Toprak A, Ozturk AM, et al. Open reduction via posterior triceps sparing approach in comparison with closed treatment of posteromedial displaced Gartland type III supracondylar humerus fractures. J Pediatr Orthop Part B. 2008 Jul;17(4):171–8.

    Article  Google Scholar 

  11. Chen RS, Liu CB, Lin XS, et al. Supracondylar extension fracture of the humerus in children using a u-shaped plaster slab with the elbow in full extension. J Bone Joint Surg Br. 2001 Aug;83(6):883–7.

    Article  CAS  PubMed  Google Scholar 

  12. Fowler TP, Marsh JL. Reduction and pinning of pediatric supracondylar humerus fractures in the prone position. J Orthop Trauma. 2006 Apr;20(4):277–81.

    Article  CAS  PubMed  Google Scholar 

  13. Cheng J, Lam T, Maffulli N. Epidemiological features of supracondylar fractures of the humerus in Chinese children. J Pediatr Orthop. 2001;10:63–7.

    CAS  Google Scholar 

  14. Parmaksizoglu AS, Ozkaya U, Bilgili F, Sayin E, Kabukcuoglu Y. Closed reduction of the pediatric supracondylar humerus fractures: the “joystick” method. Arch Orthop Trauma Surg. 2009 Sep;129(9):1225–31.

    Article  PubMed  Google Scholar 

  15. Novais EN, Andrade MA, Gomes DC. The use of a joystick technique facilitates closed reduction and percutaneous fixation of multidirectionally unstable supracondylar humeral fractures in children. J Pediatr Orthop. 2013 Jan;33(1):14-9.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. afdeling Orthopedie, Erasmus Medisch Centrum, Rotterdam, The Netherlands

    S. Moerman

  2. afdeling Chirurgie, Erasmus Medisch Centrum, Rotterdam, The Netherlands

    F.E. Buisman

  3. voorheen afdeling Chirurgie, Albert Schweitzer Ziekenhuis, Dordrecht, The Netherlands

    P.R. Schütte

  4. afdeling Chirurgie, Albert Schweitzer Ziekenhuis, Dordrecht, The Netherlands

    B.J. Punt

Authors
  1. S. Moerman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. F.E. Buisman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P.R. Schütte
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. B.J. Punt
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

1 aios orthopedie, afdeling Orthopedie, Erasmus Medisch Centrum, Rotterdam

2 anios chirurgie, afdeling Chirurgie, Erasmus Medisch Centrum, Rotterdam

3 oud-chirurg, voorheen afdeling Chirurgie, Albert Schweitzer Ziekenhuis, Dordrecht

4 traumachirurg, afdeling Chirurgie, Albert Schweitzer Ziekenhuis, Dordrecht

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Moerman, S., Buisman, F., Schütte, P. et al. Repositie van supracondylaire humerusfracturen middels een tijdelijke Kirschner-draad. TIJD. TRAUMACHIRURGIE 23, 32–36 (2015). https://doi.org/10.1007/s12506-015-0010-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12506-015-0010-4

Search

Navigation