Actualización en fracturas supracondíleas del codo en la infancia
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Resumen
Las supracondíleas son el tipo más común de fracturas en la articulación del codo durante la infancia, con un pico de presentación entre los cinco y siete años. Además constituyen el segundo tipo de fracturas más frecuente en la población pediátrica en general. El mecanismo típico de la lesión es una caída desde la altura del paciente sobre la palma de la mano con el codo en hiperextensión. El diagnóstico se basa en la sospecha clínica, según el mecanismo de la lesión y la edad del paciente, además de la radiografía simple del codo en dos proyecciones. La clasificación de Gartland es la más usada para establecer la gravedad de la fractura y guiar el tratamiento, que puede ser ortopédico en fracturas no desplazadas. El método de elección para corrección de las desplazadas es la reducción cerrada y fijación con pines percutáneos. La complicación más común es la neuropraxia del nervio mediano. Otras complicaciones son la lesión de la arteria braquial, el síndrome compartimental, la isquemia de Volkmann, el deslizamiento de los pines y el cúbito varo.
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Barrón EA, Sánchez JF, Cruz JR. Perfil clínico-epidemiológico de las fracturas supracondíleas de húmero en pacientes pediátricos en un hospital general regional. Cirugía y Cirujanos. 2015; 83(1):29-34.
Zorrilla J, Prada A, Marti R, Pretell J. Supracondylar humeral fractures in children: Current concepts for management and prognosis. SICOT. 2015; 39:2287-96.
Alton TB, Werner SE, Gee AO. Classifications In brief: The Gartland classification of supracondylar humerus fractures. Clin Orthop Relat Res. 2015; 473:738-41.
Drake RL, Vogl W, Mitchell A. Gray´s anatomy for students. 39th ed. Philadelphia, PA: Elsevier. 2005. 7th Chapter, Elbow joint: 680-85.
Drake RL, Vogl W, Mitchell A. Gray´s anatomy for students. 39th ed. Philadelphia, PA: Elsevier. 2005. 7th Chapter, Arm: 666-679.
Mencio GA, Swiontkowski MF. Green´s skeletal trauma in children. 5th ed. Philadelphia, PA: Elsevier. 2015. 10th Chapter, 1st Section: Supracondylar fractures of the humerus: 186-213.
Barrett KK, Skaggs DL, Sawyer JR, Andras L, Moisan A, Goodbody C, et al. Supracondylar humeral fractures with isolated anterior interosseous nerve injuries: Is urgent treatment necessary? J Bone Joint Surg Am. 2014; 96:1793-97.
Shrader MW. Pediatric supracondylar fractures and pediatric physeal elbow fractures. Orthop Clin N Am. 2008; 39:163-71.
Merino J, Ibor I, Rodríguez MT, Campos O, Elorriaga GM, Vicinay JI. Fracturas supracondíleas con traumatismo vascular en niños. Rev Esp Cir Ortop Traumatol. 2009; 53(5):312-16.
De Boeck H, Van Isacker T. Fractures de l’extrémité inférieure de l’humérus chez l’enfant. EMC (Elsevier Masson SAS, Paris), Appareil locomoteur, 14-041-B-10, 2007.
Badkoobehi H, Choi P, Bae D, Skaggs DL. Management of the pulseless pediatric supracondylar humeral fracture. J Bone Joint Surg Am. 2015; 97:937-43.
Thornton MD, Della-Giustina K, Aronson PL. Emergency department evaluation and treatment of pediatric orthopedic injuries. Emerg Med Clin N Am 2015; 33:423-49.
Seidel HM, Ball JW, Dains JE, Flynn JA, Solomon BS, Stewart RW. Manual Mosby de exploración física. 7° ed. España: Elsevier. 2011. Capítulo 21: Sistema musculo-esquelético: 648-701.
Babal JC, Mehlman CT, Klein G. Nerve injuries associated with pediatric supracondylar humeral fractures: A meta-analysis. J Pediatr Orthop. 2010; 30(3):253-263.
Hosseinzadeh P, Talwalkar V. Compartment syndrome in children: Diagnosis and management. Am J Orthop. 2016; 45(1):19-22.
Kanj WW, Gunderson MA, Carrigan RB, Sankar WN. Acute compartment syndrome of the upper extremity in children: Diagnosis, management, and outcomes. J Child Orthop. 2013; 7:225-33.
Campbell CC, Waters PM, Emans JB, Kasser JR, Millis MB. Neurovascular injury and displacement in type III supracondylar humerus fractures. J Pediatr Orthop. 1995; 15(1):47-52.
Lyon ST, Quinn M, Stanitski CL. Neurovascular injuries in Type III humeral supracondylar fractures in children. Clin Orthop Relat Res. 2000; 376: 62-7.
Muchow RD, Riccio AI, Garg S, Ho CA, Wimberly RL. Neurological and vascular injury associated with supracondylar humerus fractures and ipsilateral forearm fractures in children. J Pediatr Orthop. 2015; 35:121-25. 57-70 Peña CJ, Medina LM, Trujillo CI, Peña AJ, González V : MEDICINA U.P.B. 39(1) | Enero-febrero 2020 | 69
Roposch A, Reis M, Molina M, Davids J, Stanley E, Wilkins K, et al. Supracondylar fractures of the humerus associated with ipsilateral forearm fractures in children: A report of forty-seven cases. J Pediatr Orthop. 2001; 21:307-12.
Herring JA. Tachdjian´s pediatric orthopaedics: From Texas Scottish Rite Hospital for Children. 5th ed. Philadelphia, PA: Elsevier. 2013. 33th Chapter, Upper Extremity: Fractures About the Elbow: 1264-326.
Miranda I, Sánchez P, Marrachelli VG, Miranda FJ, Salom M. Orthopedic versus surgical treatment of Gartland type II supracondylar humerus fracturs in children. J Pediatr Orthop B. 2014; 23(1):93-9.
Kim TJ, Sponseller PD. Pediatric supracondylar humerus fractures. J Hand Surg Am. 2014; 39:2308-11.
Allouh MZ, Abu JH, Jarrar AA, Khasawneh RR, Mustafa AG, Bashaireh KM. The carrying angle: Racial differences and relevance to interepicondylar distance of the humerus. Folia Morphologica. 2016; 75(3):388-92.
Rajesh B, Reshma VR, Jaene RC, Somasekhar IT, Vaithilingam A. An evaluation of the carrying angle of the elbow joint in adolescents. Int J Med Biomed Res. 2013; 2(3):221-5.
Howard A, Mehlman CT, Mulpuri K, Abel MF, Braun S, Bueche M, et al. The treatment of pediatric supracondylar humerus fractures. Evidence-based guideline and evidence report. AAOS. 2011; 1-249.
Ariyawatkul T, Eamsobhana P, Kaewpornsawan K. The necessity of fixation in Gartland type 2 supracondylar fracture of the distal humerus in children (modified Gartland type 2A and 2B). Journal of Pediatric Orthopaedics B. 2016; 25:159-64.
Skaggs DL, Sankar WN, Albrektson J, Vaishnav S, Choi PD, Kay RM. How safe is the operative type 2 supracondylar humerus fractures in children? J Pediatr Orthop. 2008; 28(2):139-41.
Gheldere A, Bellan D. Outcome of Gartland type II and type III supracondylar fractures treated by Blount´s technique. Indian J Orthop. 2010; 44(1):89-94.
Camus T, MacLellan B, Cook PC, Leahey JL, Hyndman JC, El-Hawary R. Extension type II pediatric supracondylar humerus fractures: A radiografic outcomes study of closed reduction and cast immobilization. J Pediatr Orthop. 2011; 31(4):366-71.
Lewine E, Kim JM, Miller PE, Waters PM, Mahan ST, Snyder B, et al. Closed versus open supracondylar fractures of the humerus in children: A comparison of clinical and radiographic presentation and results. J Pediatr Orthop. 2018; 38(2):77-81.
Morrey BF. The elbow, master techniques in orthopaedic surgery. 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins. 2002. 3rd Chapter. Closed Reduction and Percutaneous Pinning of Supracondylar Fractures of the Distal Humerus in the Child: 49-64.
Masquijo JJ, Tocanás JM, Barrera J, Miralles M, Pedro JA. Fracturas supracondíleas del codo en los niños: enclavijado percutáneo lateral cruzado o divergente. Rev Asoc Argent Ortop Traumatol 2009; 74(1):48-54.
Jaeblon T, Anthony S, Ogden A, Andary JJ. Pediatric supracondylar fractures: Variation in fracture patterns and the biomechanical effects of pin configuration. J Pediatr Orthop. 2016; 36(8):787-92.
Sharma A, Walia JP, Brar BS, Sethi S. Early results of displaced supracondylar fractures of humerus in children treated by closed reduction and percutaneous pinning. Indian J Orthop. 2015; 49:529-35.
Woratanarat P, Angsanuntsukh C, Rattanasiri S, Attia J, Woratanarat T, Thakkinstian A. Metaanalysis of pinning in supracondylar fracture of the humerus in children. J Orthop Trauma. 2012; 26:48-53.
Skaggs DL, Cluck MW, Mostofi A, Flynn JM, Kay RM. Lateral-entry pin fixation in the management of supracondylar fractures in children. J Bone Joint Surg Am. 2004; 86:702-7.
Abdullah F, Mulpuri K, Halsey M, Nelson DG, Ho C, Oetgen M, et al. Appropriate use criteria for the management of pediatric supracondylar humerus fractures. AAOS. 2015: 1-579.
Guven MF, Kaynak G, Inan M, Caliskan G, Unlu HB, Kesmezacar H. Results of displaced supracondylar humerus fractures treated with open reduction and internal fixation after a mean 22.4 years of follow-up. J Shoulder Elbow Surg. 2015; 24:640-6.
Sarrafan N, Nasab SAM, Ghalami T. Treatment of displaced supracondylar fracture of the humerus in children by open pining from lateral approach: An investigation of clinical and radiographical results. Pak J Med Sci. 2015; 31(4):930-5.
Young S, Fevang JM, Gullaksen G, Nilsen PT, Engesaeter LB. Deformity and functional outcome after treatment for supracondylar humerus fractures in children: 5- to 10- year follow-up of 139 supracondylar humerus fractures treated by plaster cast, skeletal traction or crossed wire fixation. J Child Orthop. 2010; 4(5) 445-53.
Sadiq MZ, Syed T, Traylos. Management of grade III supracondylar fracture of the humerus by straight-arm lateral traction. SICOT. 2007; 31: 155-158.
Piggot J, Graham HK, McCoy GF. Supracondylar fractures of the humerus in children. Treatment by straight lateral traction. J Bone Joint Surg Br. 1986; 68B:577-83.
Abbott MD, Buchler L, Loder RT, Caltoum CB. Gartland type III supracondylar humerus fractures: Outcome and complications as related to operative timing and pin configuration. J Child Orthop. 2014; 8:473-7.
Schmid T, Joeris A, Slongo T, Ahmad SS, Ziebarth K. Displaced supracondylar humeral fractures: Influence of delay of surgery on the incidence of open reduction, complications and outcome. Arch Orthop Trauma Surg. 2015; 135:963-9.
Ibrahim T, Hegazy A, Abulhail SI, Ghomrawi H. Utility of the AAOS appropriate use criteria (AUC) for pediatric supracondylar humerus fractures in clinical practice. J Pediatr Orthop. 2017; 37(1):14-9.
Schroeder NO, Seeley MA, Hariharan A, Farley FA, Caird MS, Li Y. Utility of postoperative antibiotics after percutaneous pinning of pediatric supracondylar humerus fractures. J Pediatr Orthop. 2017; 37(6):363-7.
Omid R, Choi PD, Skaggs DL. Supracondylar humeral fractures in children: Current concepts review. J Bone Joint Surg Am. 2008; 90:1121-32.
Karalius VP, Stanfield J, Ashley P, Lewallen LW, DeDeugd CM, Walker J, et al. The utility of routine postoperative radiographs after pinning of pediatric supracondylar humerus fractures. J Pediatr Orthop. 2017; 37(5):309-2.
Zamaran H, Gallón LA, Echandía C. Evaluación del tratamiento y complicaciones en fracturas supracondíleas de humero distal en el Hospital Universitario del Valle. Rev Col de Or Tra. 2006; 20(1):36-45.
Gómez VE, Gil J, Herrera A. Complicaciones en las fracturas supracondíleas de humero en la infancia. Revista Española de Cirugía Osteoarticular. 2013; 48(256):150-62.
Copley LA, Dormans JP, Davidson RS. Vascular injuries and their sequelae in pediatric supracondylar humeral fractures: Toward a goal of prevention. J Pediatr Orthop. 1996; 16:99-103.
Benedetti M, Farsetti P, Martinelli O, Laurito A, Ippolito E. The value of ultrasonic diagnosis in the management of vascular complications of supracondylar fractures of the humerus in children. Bone Joint J. 2013; 95-B(5):694-8.
Sabharwal S, Tredwell SJ, Beauchamp RD, Mackenzie WG, Jakubec DM, Cairns R, et al. Management of pulseless pink hand in pediatric supracondylar fractures of humerus. J Pediatr Orthop. 1997; 17:303-10.
Brown IC, Zinar DM. Traumatic and iatrogenic neurological complications after supracondylar humerus fractures in children. J Pediatr Orthop. 1995; 15:440–3.
Bashyal RK, Chu JY, Schoenecker PL, Dobbs MB, Luhmann SJ, Gordon JE. Complications after pinning of supracondylar distal humerus fractures. J Pediatr Orthop. 2009; 29(7):704-8.
Bae DS, Kadiyala RK, Waters PM. Acute compartment syndrome in children: Contemporary diagnosis, treatment, and outcome. J Pediatr Orthop. 2001; 21(5):680-8.
Mubarak SJ, Carroll NC. Volkmann’s contracture in children: Aetiology and prevention. J Bone Joint Surg Br. 1979; 61(3):285-3.
Sankar WN, Hebela NM, Skaggs DL, Flynn JM. Loss of pin fixation in displaced supracondylar humeral fractures in children: Causes and prevention. J Bone Joint Surg Am. 2007; 89(4):713-7.
Firpo C. Fracturas y luxaciones del miembro superior. Patología traumática del codo. Manual de ortopedia y traumatología. 3ªed. Buenos aires; 2010: 220-236.
Ho CA. Cubitus varus - It’s more than just a crooked arm! J Pediatr Orthop 2017; 37:37-41.
Zhou W, Canavese F, Zhang L, Li L. Functional outcome of the elbow in toddlers with transphyseal fracture of the distal humerus treated surgically. Journal of Children’s Orthopaedics. 2019; 13(1):47-56.