fractura de húmero proximal con manejo conserva- dor, en el período comprendido .. fracturas de metáfisis distal del radio.9 Dependiendo del tipo de fractura y las se estabilizaban con placas tercio y medio tubo obteniendo resultados de. Las fracturas de antebrazo pueden ocurrir cerca de la muñeca en el extremo más alejado (distal) del hueso, en el medio del antebrazo, o cerca del codo en el . Si su niño es un atleta activo o simplemente un niño pequeño que da brincos en su cama, hay grandes probabilidades de que se caiga, en su casa o en el.
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Los botones se encuentran debajo. Algunas series de las fx en exension reportan como mas comun la lesion del radial. Esto puede ser porquese haya pasado por alto la lesion del interosio anterior que es solo motoa, o que se haya sumado a la lesion del mediano como tal la lesio del interoseo anterior que es rama de este. Nerve injuries hmero with pediatric supracondylar humeral fractures: J Pediatr Orthop ; Pooled data from 5, patients and 5, fractures was used in this study.
Fracturas supracondileas complejas del humero – ppt descargar
Ulnar nerve palsies after percutaneous cross-pinning of supracondylar fractures in children’s elbows. J Pediatr Orthop ; 18 1: Neurologic complications after K-wire fixation of supracondylar humerus fractures in children. J Pediatr Orthop ; 11 2: There were two late ulnar neurapraxias, and two direct nerve injuries during K-wire insertion, one to the ulnar and one to the radial nerve. The importance of a thorough initial neurological and vascular examination, as well as subsequent examinations immediately after treatment and during recovery is emphasized.
Of supracondylar humerus fractures treated over 4 year period by closed or open reduction and percutaneous pinning, 19 patients with normal preoperative neurologic examinations developed postoperative ulnar nerve palsies.
Only 4 patients had medial pins removed prior to fracture union, and 2 others had fractuura of the ulnar nerve dep no interruption. The authors state that postoperative ffractura nerve palsies usually resolve spontaneously, and they believe that in most cases of postoperative ulnar nerve palsy observation is ppropriate.
If the medial pin appears radiographically to be positioned in the ulnar notch, it may be appropriate to remove it and replace it more anteriorly if the pin is needed for stabilization of the fracture. Ulnar nerve injury after K-wire fixation of supracondylar humerus fractures in children. J Pediatr Orthop ; 18 5: Pain on extension of the small and fingers, and early clawing were important postoperative signs of ulnar nerve injury.
In fracturaa 6th case the nerve was anteriorly subluxated and fixed anterior to the medial epicondyle by the pin. After exploration and nerve decompression, 3 fully recovered, 2 partially recovered and one patient had no recovery. The author recommends exploration rather than simple pin removal.
Neural injuries associated with supracondylar fractures of the humerus in children. J Bone Joint Hjmero ; 72A: The pink pulseless hand: Eur J Vasc Endovasc Surg ; Explorar si persisten los signos de isquemia.
Pulseless arm in association with totally displaced diztal fracture. J Orthop Trauma ; 10 6: Traditional dsital paper of the pulseless yet perfused hand. The authors conclude that angiography is of little use and that color flow duplex imaging deserves further study.
The authors recommend exploration if signs of ischemia are present. Over a 12 year period, seven children had a pulseless arm and a seemingly viable hand after reduction and pinning of a type III supracondylar humerus fracture.
The brachial artery was directly damaged or transected and underwent saphenous vein graft repair in 3 cases, and was entrapped in the fracture and dissected free in 4 cases. Distal pulses were reestablished in each case, and long term outcome was good.
The authors recommend immediate antecubital fossa exploration if an extremity remains pulseless to palpation and Doppler examination after reduction and stabilization, rather than a waitand-watch approach.
Management of vascular injuries in displaced supracondylar humerus fractures without arteriography. J Orthop Trauma ; 4: The other three were treated with exploration of the brachial artery.
The authors believe pre-reduction arteriography is not indicated in these injuries. This study pooled data from pulseless supracondylar humeral fracture pts and polled the POSNA membership. This meta-analysis suggests that the common opinion of watchful waiting for pulseless and perfused aka pink supracondylars should be questioned.
The pulseless pink hand after supracondylar fracture of the humerus in children: These authors compared two management strategies for perfused but pulseless supracondylars: Of these 10 pts, 8 out of 10 had concomitant nerve palsies AIN or median nerve proper. The authors state that all of the other 23 pts demonstrated a degree of ischemic contracture.
Persistent and increasing pain with a deepening nerve lesion indicate that there is critical ischemia and we recommend urgent surgical exploration of the vessel and nerve in this situation. The treatment of supracondylar fractures in children with an absent radial pulse. J Pediatr Orthop ; Seven patients had a cold white hand after closed reduction and pinning, and received open reduction and arterial exploration.
The authors concluded that an absent radial pulse after closed reduction does not require routine exploration if the hand is well-perfused. Flexion-type supracondylar elbow fractures in children.
The author reports successful closed treatment of type III flexion-type injuries, although other authors have noted vractura higher likelihood these injuries will need distxl reduction. J Pediat Orthop ; La alta es por encima de la fosa fracura.
Patterns of pediatric supracondylar humerus fractures. Retrospective study of consecutive pts focusing on fracture patterns. The authors consider there to be 4 coronal and 2 sagittal patterns.
Predictors of failure of nonoperative treatment for type 2 supracondylar humerus fractures. They found that the eistal of fx extension predicted failure of cast treatment. They suggested immediate pinning of those Type II where the capitellum extends beyond the anterior humeral line. Underreduced supracondylar fracture of the humerus in children: This paper addresses issues related to sagittal and coronal alignment of supracondylar humeral fxs.
These Israeli authors reviewed supracondylar pts between and and found 30 that were underreduced. The authors recommend achieving maximal anatomical position in the coronal and sagittal planes. Las tipo 2 en flexio son mejor manejadas con pines. Delay increases the need for open reduction of type-III supracondylar fractures of the humerus.
Delay increases the need for ffffffffffffffffffffffffffffffffffffffff open reduction of type-III supracondylar fractures of the humerus. No significant differences in complication rates were identified. These authors recommended treating such supracondylars at the earliest opportunity.
Delayed treatment of type 3 supracondylar humerus fractures in children. Estudio con evidencia debil pero no se uede rendomizar por cuetiones eticas. Retrospective review of type III fractures did not find any correlation between length of time between bumero and surgical treatment with regard to increased operative time, need for open reduction, length of hospital stay or unsatisfactory result.
Fracturas supracondileas complejas del humero
The average time from injury to surgery was All nerve injuries resolved by 6 month follow-up. Delayed treatment is equivalent to emergent treatment in closed type III fractures with no associated neural or vascular injuries. Early versus delayed treatment of extension type-3 supracondylar fractures of the humerus in children. J Bone Joint Surg-Br ; Fracturas desplazadas no complicadas no tienen que ser tratadas en la noche.
Early versus delayed treatment of extension type-3 fffffffffffffffffffffffffffffffffffff supracondylar fractures of the humerus in children. No significant differences in perioperative complications were identified. The authors concluded that uncomplicated supracondylar fxs could be treated early or delayed. Aqui sale la manobra de reduccion de las de flexion. Brachialis muscle entrapment in displaced supracondylar humerus fractures: A technique of closed reduction and report of initial results.
Retrospective review where 20 of 92 type III fractures were initially irreducible, and in 18 of these brachialis muscle interposition was diagnosed by physical examination cubital fossa ecchymosis, dimpling of skin anteriorly over fracture site, palpable proximal fragment in subcutaneous tissues anteriorly or intraoperative findings.
Surgical technique for supracondylar fracture of the humerus with percutaneous leverage pinning. J Should Elbow Surg: Manipulation of pediatric supracondylar fractures of humerus in prone position under general anesthesia.
Relationship of the anterior humeral line to the capitellar ossific nucleus: J Bone Joint Surg ;A: Three observers measured 30 x-rays on two occasions for this study. Normal characteristics of the Baumann humerocapitellar angle: An aid in assessment of supracondylar fractures.
The Baumann angle was evaluated in normal children. Bunnel WP, Duhaime M, et al: Cubitus varus deformity following supracondylar fractures of the humerus in children. J Pediatr Orthop ; 2: A review of 63 patients with cubitus varus deformities, in whom no growth drl was apparent.