A treatment approach to pediatric supracondylar femur fracture

Pediatric supracondylar femur fractures are uncommon and only few publications regarding this subject are available in the current literature. Between 1990 and 2009, 279 pediatric femur fractures were retrospectively analyzed and 16 (5.7%) supracondylar femur fractures were detected. Predisposing musculoskeletal diseases were determined in three of these 16 patients [(osteogenesis imperfecta (2), cerebral palsy (1)]. Six patients who had non-displaced fracture were performed direct casting; after 3 weeks following traction under anesthesia, four patients underwent pelvipedal cast treatment. Percutaneous crossed K-wire fixation and a long-leg cast was applied in six patients. Fusion related problem and infection were not observed in any of the patients. During the postoperative follow-up, claudication was detected in two patients. One of them with cerebral palsy had concomitant high hip dislocation on the same side. Range of motion was normal in all except two patients who had claudication. Of these, one with 30° and the other with 10° extension loss were observed.

Çocuk suprakondiler femur kýrýklarýna tedavi yaklaþýmý

Çocuk suprakondiler femur kýrýklarý yaygýn olarak görülmemektedir ve literatürde bu konu ile ilgili az sayýda yayýn mevcuttur. 1990-2010 yýllarý arasýnda retrospektif olarak incelenen 279 çocuk femur kýrýðý olgusunun 16’sýnda (%5,7) suprakondiler femur kýrýðý tespit edilmiþtir. Femur kýrýðý tespit edilen bu 16 hastanýn üçünde predispozan muskuloskletal hastalýklar tespit edildi [osteogenesis imperfecta (2), serebral palsi (1)]. Nondeplase kýrýðý olan altý hastaya direkt alçýlama, dört hastaya üç hafta traksiyonu takiben anestezi altýnda pelvipedal alçýlama ve altý hastaya da perkütan çapraz K teli ile tespit ve uzun bacak alçýlama yapýldý. Hiçbir hastada kaynamama ve enfeksiyon görülmedi. Ameliyat sonrasý takiplerde iki hastada topallama þikayeti tespit edildi. Bu hastalardan birinde serebral palsi ile beraber ayný tarafta yüksekte kalça çýkýðý vardý. Eklem hareket açýklýklarý serebral palsili hastada 30°, diðer hastada 10° ekstansiyon kaybý dýþýnda kalan 14 hastada tam olarak tespit edildi.