Health Outcomes of Elbow Fractures in Iraqi Children and Assessment of Risk Factors
Keywords:
Elbow fractures, Iraqi children, Risk factors, ComplicationsAbstract
Background: Fractures of the elbow are the most common, accounting for 14 percent of fractures in children.
Objective: We contributed to the evaluation of health findings related to children with elbow fractures and the identification of risk factors and effects on children who participated in this study.
Methods: A cross-sectional study was conducted on Iraqi paediatric patients with elbow fractures who attended the emergency department of hospitals in Baghdad, Iraq. The patients were aged between 5 and 16 years old, and a total of 72 samples were included in the study. This study documented the clinical and demographic outcomes of paediatric patients. A univariate analysis was conducted to identify the risk factors affecting the health status of Iraqi children.
Results: A total of 72 children were included in the study, with the objective of analysing the clinical outcomes of elbow fractures. The age group with the highest number of recorded cases was that of 13- to 16-year-olds, representing 44.44% of the total. There were 47 cases of boys and 25 cases of girls. The most common type of elbow fracture was the supracondylar fracture, which accounted for 47.22% of cases, followed by the right elbow fracture (56.94%) and the left elbow fracture. The most common cause of elbow fractures was identified as falls onto an outstretched arm, accounting for 43.06% of cases. Among the patients who underwent intervention, 40 underwent open reduction, and 32 underwent internal fixation (ORIF). The success rate was 76.39%.
Conclusion: In general, ORIF and CRPP are the best procedures among all others for treating fractures in the elbow of children.
References
Wilkins KE. Fractures and dislocations of the elbow region. In: Rockwood CW, King RE, editor. Lipponcott-Raven1996. p. 653–887.
Sinikumpu JJ, Lautamo A, Pokka T, Serlo W. Complications and radiographic outcome of children's both-bone diaphyseal forearm fractures after invasive and non-invasive treatment. Injury. 2013;44 (4):431-6.
Von Laer L. Pediatric fractures and dislocations. Pediatric fractures and dislocations. Stuttgart, Germany: Thieme; 1st edition; 2004. p. 528.
Lieber J, Zundel SM, Luithle T, Fuchs J, Kirschner HJ. Acute traumatic posterior elbow dislocation in children. Journal of Pediatric Orthopedics Part B. 2012;21 (5):474-81.
Rasool MN. Dislocations of the elbow in children. The Journal of bone and joint surgery British volume. 2004;86 (7):1050-8.
Kirkos JM, Beslikas TA, Papavasiliou VA. Posteromedial dislocation of the elbow with lateral condyle fracture in children. Clinical orthopaedics and related research. 2003 (408):232-6.
Murphy RF, Vuillermin C, Naqvi M, Miller PE, Bae DS, Shore BJ. Early Outcomes of Pediatric Elbow Dislocation-Risk Factors Associated with Morbidity. Journal of Pediatric Orthopedics. 2017;37 (7):440-6.
Lawrence JT, Patel NM, Macknin J, Flynn JM, Cameron D, Wolfgruber HC, et al. Return to competitive sports after medial epicondyle fractures in adolescent athletes: results of operative and nonoperative treatment. The American journal of sports medicine. 2013;41 (5):1152-7.
Josefsson PO, Danielsson LG. Epicondylar elbow fracture in children. 35-year follow-up of 56 unreduced cases. Acta orthopaedica Scandinavica. 1986;57 (4):313-5.
Pring ME. Pediatric radial neck fractures: when and how to fix. Journal of Pediatric Orthopedics. 2012;32 Suppl 1: S14-21.
BF M. Functional evaluation of the elbow. In: Morrey BF AK CE, editor. WB Saunders1993. p. 86– 9.
Reed MW, Reed DN. Acute ulnar nerve entrapment after closed reduction of a posterior fracture dislocation of the elbow: a case report. Pediatric emergency care. 2012;28 (6):570-2.
Carlioz H, Abols Y. Posterior dislocation of the elbow in children. Journal of Pediatric Orthopedics. 1984;4 (1):8-12.
Hughes M, Dua K, O'Hara NN, Brighton BK, Ganley TJ, Hennrikus WL, et al. Variation Among Pediatric Orthopaedic Surgeons When Treating Medial Epicondyle Fractures. Journal of Pediatric Orthopedics. 2019;39 (8): e592-e6.
Pathy R, Dodwell ER. Medial epicondyle fractures in children. Current opinion in pediatrics. 2015;27 (1):58-66.
Gottschalk HP, Eisner E, Hosalkar HS. Medial epicondyle fractures in the pediatric population. The Journal of the American Academy of Orthopaedic Surgeons. 2012;20 (4):223-32.
Patrick J. Fracture of the medial epicondyle with displacement into the elbow joint. The Journal of bone and joint surgery American volume. 1946; 28:143-7.
Newman JH. Displaced radial neck fractures in children. Injury. 1977;9 (2):114-21.
Roberts PH. Dislocation of the elbow. The British journal of surgery. 1969;56 (11):806-15.
Schmittenbecher PP. What must we respect in articular fractures in childhood? Injury. 2005;36 Suppl 1: A35-43.
Gausepohl T, Mader K, Kirchner S, Pennig D. The "floating forearm" injury in a child: a case report. Strategies in trauma and limb reconstruction. 2007;2 (1):48-54.
Schmittenbecher PP, Haevernick B, Herold A, Knorr P, Schmid E. Treatment decision, method of osteosynthesis, and outcome in radial neck fractures in children: a multicenter study. Journal of Pediatric Orthopedics. 2005;25 (1):45-50.
Sofu H, Gursu S, Camurcu Y, Yildirim T, Sahin V. Pure elbow dislocation in the pediatric age group. International orthopaedics. 2016;40 (3):541-5.
Linscheid RL, Wheeler DK. Elbow dislocations. Jama. 1965;194 (11):1171-6.
Schwab GH, Bennett JB, Woods GW, Tullos HS. Biomechanics of elbow instability: the role of the medial collateral ligament. Clinical orthopaedics and related research. 1980 (146):42-52.
Beaty JH KJ. Elbow dislocation fractures in children. 663–79 p.
Royle SG. Posterior dislocation of the elbow. Clinical orthopaedics and related research. 1991 (269):201-4.
Hopf JC, Berger V, Krieglstein CF, Müller LP, Koslowsky TC. Treatment of unstable elbow dislocations with hinged elbow fixation-subjective and objective results. Journal of shoulder and elbow surgery. 2015;24 (2):250-7.
Wilmshurst AD, Millner PA, Batchelor AG. Brachial artery entrapment in closed elbow dislocation. Injury. 1989;20 (4):240-1.
Fowles JV, Slimane N, Kassab MT. Elbow dislocation with avulsion of the medial humeral epicondyle. The Journal of bone and joint surgery British volume. 1990;72 (1):102-4.
Di Gennaro GL, Spina M, Fosco M, Antonioli D, Donzelli O. Dislocations of the elbow in children: long-term follow-up. Musculoskeletal surgery. 2013;97 Suppl 1:3-7.
Kaziz H, Naouar N, Osman W, Ayeche M. Outcomes of Pediatric Elbow Dislocations. Malaysian Orthopaedic Journal. 2016;10 (1):44-9.
Michelsson JE, Rauschning W. Pathogenesis of experimental heterotopic bone formation following temporary forcible exercising of immobilized limbs. Clinical orthopaedics and related research. 1983 (176):265-72