Role of arthrography of elbow in the management of lateral condyle fracture of humerus in children
|IJOCP | Volume – 2015| Issue – 2015| Article ID – 2015:76
Conference: Indian Orthopaedic Association Annual Conference IOACON-2013, India [Click for Full details]
Authors: Dudani B, Shyam A
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Background: Cartilagenous intra articular part of lateral condyle in children is difficult to visualise on plain radiographs. Visualisation of the cartilagenous part can have a bearing in accurate assessment of fracture morphology , stability as well as quality of reduction . Arthrography can accurately delineate the intra articular cartilaginous fracture geometry. We performed arthrography under image intensifier to guide the fracture reduction, fixation and facilitate closed reduction. We report the use of this technique in 11 of our patients. Patients and
Methods: 11patients including 8boys and 3 girls. The mean age was 4.45 years (2-8yrs, S.D of 2.00). These patients were evaluated between May 2011 and January 2013. Plain radiographs 2 views(Anteroposterior & lateral) and occasionally internal oblique view were taken. Jakob’sstaging for displacement of fracture was used to classify them. There were 2 stage I, 2 stage II and 7 stage III fractures. Image intensifier was used in all cases to perform arthrography.
Results: All stage I and stage II fractures could be closed reduced and fixed when cartilage hinge was broken. 1 stage I fracture with intacthinge was treated with an above elbow cast. 5 out of 7 stage III (71%) fractures which usually require open reduction could be closed reduced due to better delineation of fracture anatomy using arthrography. 2 stage III fractures still required open reduction. Average time of cast and ‘K’ wire removal was 29.27 (28-31, S.D of 1.1) days. All fractures healed without complications with mean union time of 10.54 (9-12, S.D of 0.9) weeks.
Conclusion: Arthrography can help in better understanding of fracture geometry and facilitate dynamic intraoperative reduction. This may help in reducing the requirement of open reduction in these fractures. It may also help in limiting the dissection required while performing open reduction and internal fixation.
|How to Cite this Abstract|
|Dudani B, Shyam A. Role of arthrography of elbow in the management of lateral condyle fracture of humerus in children . International Journal of Conference Proceedings 2015;(2015):76|