Universität zu Köln

Ott, N., Hackl, M., Leschinger, T., Wegmann, K. and Mueller, L. P. (2020). Predictors of avascular necrosis of the trochlea after pediatric supracondylar humerus fractures A systematic review. Obere Extremitaet-Schulter-Ellenbogen-Hand, 15 (4). S. 301 - 307. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1862-6602

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Abstract

Background Supracondylar fractures of the humerus are the most common type of elbow fractures in childhood. Due to the potential risk of severe complications, trauma surgeons should address them with caution. Avascular necrosis of the trochlea presents a rare but oftentimes disabling complication and should not be underestimated. The aim of the present study was to identify possible predictors of avascular necrosis of the trochlea following pediatric supracondylar humerus fractures. Methods We reviewed the available body of literature reporting clinical outcomes, complications, and possible predictors of avascular necrosis of the trochlea after supracondylar humerus fractures in childhood. Data on patient age, sex, the affected side, fracture classification, treatment, the number of K-wires, time to surgery, complications, and the time from injury to diagnosis of avascular necrosis were obtained. This study was performed according to the PRISMA guidelines. Results Eight clinical studies were included, comprising 30 patients with avascular necrosis after supracondylar fractures in childhood. The mean age at the time of injury was 5 years (min. 2; max. 10; SD: 2.8 years). In all, 18 patients (60.0%) were male, 11 (36.7%) were female, and one was unknown (3.3%). Five patients (16.7%) had a Gartland type I, three (10.0%) a type II, and 22 (73.3%) a type III fracture of the distal humerus. Six patients (20.0%) were treated conservatively, whereas 24 patients (80.0%) underwent operative treatment. The mean time from injury to diagnosis of avascular necrosis was 33 months (min. 4; max. 84; SD: 24.5 months). Conclusion The available literature on avascular necrosis of the trochlea following pediatric supracondylar humerus fractures is limited. While it can occur in any supracondylar fracture, fracture displacement may be considered a risk factor.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Ott, N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hackl, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Leschinger, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wegmann, K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, L. P. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-315337
DOI:	10.1007/s11678-020-00606-9
Journal or Publication Title:	Obere Extremitaet-Schulter-Ellenbogen-Hand
Volume:	15
Number:	4
Page Range:	S. 301 - 307
Date:	2020
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1862-6602
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language FISHTAIL DEFORMITY; DISTAL HUMERUS; DISSOLUTION; CHILDREN; ELBOW Multiple languages Orthopedics Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/31533