Monday, 27 January 2014

Sc fracture

#supracondylar humerous
5 -8 yrs mc age
boys > girls
fall on outstretched hand hyperextension injury
left side > right side
mc injury of elbow in children
types-
1.mc extension type[97-99%] (posteromedial 70-80%;posterolateral 20-30%) distal fragnent extended (tilted backward/posterior )
2.flexion type 1-3% only
distal fragment anterior forward flexed

pain swelling of elbow
loss of movement
S shaped deformity
three point bony relationship maintained
dimple sign
Gartland classification
type 1 undispaced # -only cast for 3 week
type 2 angulated # with post cortex still in continuity -reduce under GA;wiring
type 3 displaced completly-rx of either type 2 or ORIF

complications-
early - brachial artrry injury; median nerve injury (radial /ulnar may be )

late- malunion mc
gun stock deformity
cubitus varus
elbow stiffness
VIC

rx of cubitus varus
french /modified french( close wedge lateral osteotomy)
king's osteotomy ( medial open wedge)
derotation osteotomy

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