Anteromedially Displaced Supracondylar Fracture of the Humerus in Children
10.4055/jkoa.1990.25.3.812
- Author:
Bong Keun KIM
- Publication Type:Original Article
- Keywords:
Supracondylar;
Anteromedially Displaced;
Humerus;
Children
- MeSH:
Child;
Elbow;
Forearm;
Humans;
Humerus;
Olecranon Process
- From:The Journal of the Korean Orthopaedic Association
1990;25(3):812-823
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
1. Fifteen cases of anteromedial supracondylar fracture of the humerus in children were treated during a 15-year-period since 1975. 2. The anteromedial fracture were classified into flexion-varus and adduction-antilt type and subdivided into angulation and shear fracture. 3. The characteristic roentgenographic manifestations of the anteromedial fracture are: 1) Flexion varus fracture:Segmental fracture of the wall of the olecranon and coronoid fossa with fracture of the anterior and posterior cortex of metaphysis on lateral view. 2) Adduction-antilt fracture:The longitudinally split fracture of the anterior and posterior cortex of the metaphysis and tension fracture on the posterior fragment with medial impaction of the distal fragment. 4. Adduction-antilt fracture should be treated by manipulative reduction and fixation in plaster in abduction of the elbow. The full extension is necessary to fix the elbow which can afford to abduct the forearm securely to definite direction. 5. Anteromedially displaced fracture can be fixed by two percutaneous K wire pinning. On the lateral side, the pin is directed upward and medially at an angle of 45 degrees to the fracture line and intramedullary vertical to the coronal plane of the humerus. On the medial side the pin is directed upward along the axis of the medial column and inserted into medullary canal (vertical pin). On the lateral projection, the pin is introduced through the distal fragment and the anterior distal end of the proximal fragment, contact point between fragments to penetrate the opposite cortex. The pin is securely fixed at the two point-opposite cortex and anterior distal end of the proximal fragment.
