THE EFFECTIVENESS OF CLOSED REDUCTION OF SUPRACONDYLAR FRACTURE OF THE HUMERUS WITH NEUROVASCULAR INJURY IN TERMS OF THE NEED FOR EXPLORATION IN CHILDREN | [Journal of Medical Science • 2021]

Author(s):

1. Muhammad Younas Khan: Department of Orthopedics, Khyber Teaching Hospital,Peshawar ,Pakistan

2. Muhammad Shoaib Khan: Department of Orthopedics, Khyber Teaching Hospital, Peshawar, Pakistan

3. Muhammad Afrasiyab Javed Khan: Department of Orthopedics, Khyber Teaching Hospital,Peshawar, Pakistan

4. Ahsan Sajjad: Department of Orthopedics, Khyber Teaching Hospital,Peshawar ,Pakistan

5. Muhammad Khalid Khan: Emergency Satellite Hospital, Nehaqi, Peshawar - Pakistan

6. Farwa Shoaib: Kabir Medical College,Peshawar,Pakistan

Abstract:

Objective: To determine the effectiveness of closed reduction of supracondylar fracture of the humerus in children with neurovascular injury in terms of the need for exploration. Material and Methods: This prospective observational study was conducted at the department of Orthopedic Khyber Teaching Hospital Peshawar from July 2020 till July 2021. Children with supracondylar fracture (Gartland type II and III) of the humerus were included irrespective of neurovascular injury. Data was analyzed using SPSS. Mean and standard deviation was used for quantitative data. Frequency and percentages were used for qualitative data. Shapiro Wilk's test was done to find the normality of the data. Results: The mean age of the 65 children with Gartland type 3 closed fractures was 7 years (± 1.5) years. The male to female ratio was 1:0.4 with 45 males and 20 female patients. The right side was involved in 28 (43%) while left sides in 37(57%) patients. At presentation, 40 patients (61%) had no signs of neurovascular involvement while 25 patients (39%) had signs and symptoms of various nerve injuries and 6 patients had absent radial pulse but with well perfused, pink hand. Of these 25 patients, only 2 patients had combined neurovascular compromise not responding to closed reduction and needed urgent exploration while the remaining 23 were managed conservatively with closed reduction Conclusion: This study concludes that closed reduction should be done in patients with isolated nerve injury or vascular injury with pink hand and adequate capillary refill while in case of combined nerve and vascular injury not responding to closed reduction, urgent exploration should be considered.

Page(s): 291-294

DOI: DOI not available

Published: Journal: Journal of Medical Science, Volume: 29, Issue: 4, Year: 2021

Keywords:

Ulnar nerve , Median nerve , Radial nerve , Gartland classification , Neurovascular injuries , Supracondylar fracture of the humerus

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