Level III, retrospective comparative study.Ĭlosed reduction humerus fracture paediatric splinting in situ supracondylar fracture. ![]() Splinting in situ reduces anaesthesia exposure without increasing postoperative complications or suboptimal outcomes. Patients treated without ED reduction were taken to the OR sooner and remained in the hospital for a shorter period of time. No difference in complications or outcomes was found between patients with Type II or III supracondylar fractures treated initially with or without closed reduction in the ED. Patients managed without reduction in the ED had a lower average delay from ED to OR compared with those treated with reduction (16 hours versus 22 hours, p < 0.005) and a shorter hospital length of stay (34 hours versus 40 hours, p < 0.005). application of a spica splint is necessary if temporary coaptation is deemed appropriate for these fracture locations. There was no significant difference between the groups related to demographic factors or fracture characteristics. Selected humerus/femur fractures or elbow luxations may benefit from temporary immobilization in a spica splint if a protracted delay until definitive treatment or lengthy patient. In all, 157 patients were included, 89 with reduction in the ED and 68 without. Nonoperative treatment by splinting is only indicated for undisplaced, extraarticular fractures, such as 13-A type fractures. ![]() The Fisher's exact test was used for categorical variables and the Wilcoxon rank sums tests for continuous variables. Radiographic outcomes were assessed at follow-up. Patients less than ten years old with a Gartland type II or III supracondylar humerus fracture between 20 were included. The indications of surgery are neurovascular damages. The purpose of this study was to investigate if outcomes or complications differ between these two management methods. Traditionally, the first treatment of humerus shaft fractures was closed reduction and splinting. In 2012, our management of patients with a displaced fracture changed from closed reduction in the emergency department (ED) to in situ splinting prior to closed reduction and pinning in the operating room (OR). His extensive experience as a top orthopedic surgeon can ensure you get the best treatment for a quick recovery.Displaced supracondylar humerus fractures are treated with open or closed reduction and percutaneous pinning. If you have a humerus fracture that needs treatment in the San Francisco Bay Area, contact Dr. If displacement or multiple fractures occur, surgery may be required to add screws, pins or plates to repair the bone. Immobilizing the shoulder and upper arm can allow healing. There are several different types of fractures that can occur, but most can be treated with conservative methods. A fall with an outstretched hand can cause the fracture, as can impact in other accidents. A swathe is another immobilization option that provides extra support and further reduces movement by. Proximal humerus fractures are more common in the elderly, especially those with osteoporosis. Wearing a sling provides arm support and immobilization. Physical therapy is required to regain mobility and strength. A splint or cast is usually not needed a sling may be recommended to support the arm as it heals. ![]() Pins, screws or plates may be used to hold the bone in place as it heals. Patients in both groups were similar with regards to initial injury displacement and radial nerve. In some cases, surgery may be required for a humerus fracture. All five nonunions were in the coaptation splinting group. The bone is allowed to heal naturally, with physical therapy used to regain strength and mobility. Only the upper arm is immobilized, with the elbow left free. Initial treatment is to place the arm in the correct position for healing and immobilize the elbow in a splint or brace. Often, non-surgical treatment can be used, but surgery intervention may be needed, depending on the extent of the break.įor upper arm bone fractures in the shaft of the humerus, immobilization with a splint, brace or cast may be used if the bone can be realigned. The humerus can be broken at the top of the bone near the shoulder, a proximal humerus fracture, or in the shaft of the bone. Falls, sports injuries and auto accidents are the most common causes of humerus fractures and other shoulder injuries. The humerus, or upper arm bone, extends from the shoulder to the elbow, connecting to both joints.
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