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Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_II | Pages 163 - 163
1 Feb 2004
Beslikas T Mantzios L Anast P Panos N Nenopoulos S Papavasiliou V
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Purpose: The supracondylar fractures of the distal humerus are the second most frequent fractures of the developing skeleton. Also their immediate and late complications are very often. The aim of this study is to describe their neurological complications.

Material – methods: In our department 178 children were admitted with supracondylar fracture of the distal humerus during the period 1998–2002. Their age ranged from 2 to 16 years of age (the average was 7 years old, 63 girls and 115 boys). Forty-six patients were treated conservatively and 132 surgically. Neurological complications were appeared in 18 patients that had, according to Gartland classification, II and III type fractures. Manipulations for closed reduction had been made to 6 of them. Neurological deficit of the median nerve appeared to 10 patients, of the radial nerve to 6 patients and of ulnar nerve to 2 patients. The treatment of the fractures was surgical (open reduction, internal fixation with Kirschner wires and immobilization with a long arm cast for 4 weeks). The treatment of the neurological complications was conservative (free mobilization of the elbow was followed after the removal of the arm cast and Kirschner’s wires).

Results: The results of the conservative treatment of the neurological complications of the supracondylar fractures of the distal humerus were excellent and the surgical exploration on the injured nerve was not necessary on any patient. The function of the nerves recovered completely in 2–3 months after the elbow’s fracture.

Conclusion: The prognosis on the neurological complications of the upper limbs due to supracondylar fracture of the distal humerus is very good. They are successfully treated conservatively and the surgical exploration on the injured nerve is rarely necessary.


Orthopaedic Proceedings
Vol. 85-B, Issue SUPP_III | Pages 224 - 224
1 Mar 2003
Beslikas T Mantzios L Iosifidou E Panos N Kapetanos G Papavasiliou V
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Introduction: The open reduction of C.D.H. (Congenital Dislocation of the Hip) during infancy associated with an incomplete osteotomy of the iliac bone in the roof of the acetabulum with a use of a wedge bone graft are described in this study.

Material and Methods: Ten children with C.D.H. (aged from 5 to 12 months) were surgical treatment under gone during the last 2 years in our department. Eight of them were boys and 2 girls. The left hip joint was involved in 7 and the right in 2 while one patient had bilateral C.D.H.Conservative treatment without success was performed in all patients until their admission in our hospital. The treatment’s method was the same in all the patients. By an anterior approach to hip joint with a Smith – Petersen’s skin incision open reduction of the dislocated hip was succeeded. We had to eliminate the teres ligament, cut the insertion part of the iliopsoas tendon and remove the inverted limbus to achieve reduction of the hip.

An incomplete innomitate osteotomy was followed above to the roof of the acetabulum. A corticotrabecular wedge human bone graft .human in 3 cases or a allograft in 7patients ( 8 hips) were used to reconform the acetabulum.

Results: The follow-up time ranged from 1 to 2 years. Normal range of movements was detected during clinical review. The radiological follow-up findings were shown that the bone roof of the acetabulum and the femoral neck anteversion was reconformed. No avascular necrosis of the femoral head was noticed.

Conclusion: The C.D.H. could be perfectly recostucted during infancy by open reduction associated with a use of a corticotrabecular wedge bone graft.