title: Metaphyseo-diaphyseal junction fracture of distal humerus in children.
abstract: Six metaphyseo-diaphyseal junction fractures of distal humerus and 182 supracondylar fractures of humerus treated in our institute over a period of 5 years were retrospectively analyzed. Clinical data regarding child's age, neurovascular status, mechanism of injury, mode of treatment, and ultimate clinical outcome were collected for both these fractures and a comparison was made. Oblique (n=2), comminuted (n=3), and transverse types (n=1) of fracture patterns were identified at distal humeral metaphyseo-diaphyseal junction. The oblique and comminuted fractures were managed by closed reduction and plaster of Paris cast, whereas the only transverse fracture was treated by closed reduction and Kirschner wire fixation. In contrast, 125 patients of supracondylar fractures were treated by closed reduction and plaster of Paris cast and the remaining 57 fractures needed Kirschner wire fixation after closed reduction. Assessment by Flynn criteria after 1 year after of injury revealed better functional outcome in metaphyseo-diaphyseal junction fractures. Although transverse fractures are unstable and may require surgical fixation; oblique and comminuted fractures at the metaphyseo-diaphyseal junction of distal humerus can be managed conservatively.
authors: Department of Orthopaedics, Postgraduate Institute of Medical Education and Research, Chandigarh, India. senrameshpgi@yahoo.in
authors: Ramesh Kumar
authors: RK
authors: Sen
authors: Sujit Kumar
authors: SK
authors: Tripathy
authors: Amit
authors: A
authors: Kumar
authors: Amit
authors: A
authors: Agarwal
authors: Sameer
authors: S
authors: Aggarwal
authors: Sarvdeep
authors: S
authors: Dhatt
mesh_terms: D002370:Casts, Surgical; D002648:Child; D002675:Child, Preschool; D018483:Diaphyses / Q000293:injuries*; D016267:External Fixators; D005260:Female; D005592:Fracture Fixation / Q000379:methods*; D006801:Humans; D006810:Humeral Fractures / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000628:therapy; D007593:Joint Instability / Q000209:etiology; D008297:Male; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications; D011859:Radiography; D012189:Retrospective Studies; D015599:Trauma Severity Indices; D000092464:Elbow Injuries