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Operative treatment of fracture of medial epicondyle of humerus in children
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Ho Jung Kang, Yong Min Cheon, Kye Wook Song, Eung Shick Kang, Hui Wan Park
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J Korean Soc Fract 2001;14(4):762-768. Published online October 31, 2001
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DOI: https://doi.org/10.12671/jksf.2001.14.4.762
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 Abstract
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- PURPOSE
We investigated injury mechanism, clinical feature, treatment, and prognosis in fracture of medial epicondyle of humerus in children.
MATERIAL AND METHOD: From April 1997 to April 2000, 10 fractures of medial epicondyle of humerus treated by operative method and followed up for minimum 12 months were analyzed retrospectively.
RESULTS
The injury mechanism includes slip down with elbow outstretched in 8 case, throwing ball in one case, arm wrestling in other one case. Ulnar nerve symptom at the distal region of fracture site was noted in one case. 2 cases had elbow dislocation at the time of trauma. Fractured fragment displaced more than 5mm in 9 cases and fractured fragment incarcerated in elbow joint in one case. Open reduction and internal fixation was done with medial approach. The mean period of cast immobilization was 6 weeks postoperatively and after removal of cast, gentle exercise of range of motion was started. After operation and postoperative follow up, in all case except one, the full range of motion of elbow joint was recovered and there were no Unar nerve symptom and valgus instability in affected elbow joint.
CONCLUSION
The indication of operation for fracture of medial epicondyle of humerus is controversial, yet. We had done open reduction and internal fixation for medial epicondyle of humerus only in case of displacement of fractured fragment more than 5mm and incarceration in elbow joint after manual reduction, ulnar nerve symptom. In 90 percents of all case, the result was satisfactory.
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Operative treatment of Radial neck fractures in Children
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Ho Jung Kang, Jae Hoon Jun, Kye Wook Song, Soo Bong Hahn, Eung Shick Kang
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J Korean Soc Fract 2001;14(4):745-752. Published online October 31, 2001
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DOI: https://doi.org/10.12671/jksf.2001.14.4.745
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Abstract
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- OBJECTS: Radial neck fractures are uncommon in children, and most cases were treated by conservative treatment or manual reduction. But if proximal fragment is angulated more than 30 degrees, and displaced more than 30%, operative treatment is needed. Operative treatment is also needed in cases of closed reduction failure or in type IV of Salter-Harris classification. If open reduction is not performed, limitation of motion, altered carrying angle and radiologic change occur. We retrospectively analyzed 12 patients who had operative treatment for radial neck fractures in children.
MATERIALS AND METHODS
From April 1996 to December 1998, 12 patients with radial head fracture, were admitted to our hospital and were treated by operation. The average age of 9 years and 6 months (range 5 years 11 months to 14 years). Falling down was most common cause of injury. Seven cases were treated by open reduction and 5 cases by closed reduction. On open reduction group, 3 cases were fixed by Kirschner wire and 4 cases fixed by mini-screw. On closed reduction group, 3 cases were reduced percutaneously using steinmann pin, 1 case reduced using curet, and I case was fixed with Kirschner wire.
RESULTS
Ten cases were evaluated as good or excellent by criteria for judging results of radial neck fracture by Tibone and Stortz. Three cases had complication of heterotopic ossification, two cases had complication of limitation of motion. and one case had complication of pin loosening.
CONCLUSION
The operative treatment for radial neck fracture in children, improved the results of physical examination and roentgenographic evaluation. So operative treatment is needed for radial neck fracture in children which are more than 30 degrees angulation, more than 30% displacement and with displaced epiphyseal plate injury.
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