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A Standardized Method for Measurement of Elbow Kinesthesia
Published on: October 10, 2020
Pediatric floating elbow
D Ring1, P M Waters, R N Hotchkiss
1Department of Orthopaedics, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts 02115, U.S.A.
Journal of Pediatric Orthopedics
|July 4, 2001
Summary
Pediatric floating elbow injuries can lead to compartment syndrome with traditional casting. Percutaneous Kirschner wire fixation allows for safer immobilization, reducing swelling and compartment syndrome risks in children.
Area of Science:
- Orthopedic Surgery
- Pediatric Orthopedics
- Trauma Surgery
Background:
- Floating elbow injuries in children present significant management challenges.
- Circumferential cast immobilization is associated with a high risk of compartment syndrome.
Purpose of the Study:
- To evaluate the safety and efficacy of percutaneous Kirschner wire fixation for pediatric floating elbow injuries.
- To compare outcomes between traditional cast immobilization and Kirschner wire fixation.
Main Methods:
- Retrospective review of 16 pediatric patients with floating elbow injuries.
- Analysis of immobilization techniques: closed reduction with plaster cast versus percutaneous Kirschner wire fixation.
- Assessment of complications including compartment syndrome, swelling, and need for remanipulation.
Main Results:
- Two patients (20%) developed compartment syndrome with plaster immobilization; four more had incipient compartment syndrome requiring cast splitting.
- One patient with compartment syndrome developed Volkmann ischemic contracture.
- Zero patients (0%) experienced compartment syndrome or excessive swelling when treated with percutaneous Kirschner wire fixation and split casting.
Conclusions:
- Percutaneous Kirschner wire fixation of both distal humeral and forearm fractures is a safe and effective treatment for pediatric floating elbow injuries.
- This technique allows for non-circumferential immobilization, significantly reducing the risk of compartment syndrome.
- Kirschner wire fixation offers a superior alternative to traditional cast immobilization for these complex pediatric fractures.
