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Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_11 | Pages 2 - 2
1 Feb 2013
Quick T Carpenter C Gibbons P Little D Skowno J
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Aim. Vascular compromise following supracondylar fractures is frequently described. Near Infra-red Spectrometry (NIRS) is a technique through which real-time data can be gathered non-invasively on the oxygenation status of tissues. The drive now is to gain knowledge on how NIRS data can be interpreted and to validate its use in the clinical setting. Methods. This ethically approved prospective study looks at volar forearm compartment oxygen saturation (StO2) in 20 patients with supracondylar fractures requiring operative intervention. Both the injured limb and the contra-lateral, uninjured limb were monitored. 20 patients from a cohort of 29 had full data sets and are thus presented. Results. 12 patients were neurovascularly intact. Eight patients showed some neurovascular compromise. There was no difference (P=0.3475) between the StO2 of the injured and non-injured arms of the neurovascularly intact patients. Of the eight arms with an altered neurovascular status, four were pink and pulseless. We encountered no compartment syndromes in this series. Comparing the StO2 from the neurovascularly altered limbs (mean 66.84% range 45.43–89.53% SD 15.90) and the neurovascularly intact limbs (mean 81.62% range 64.21–98.89% SD 9.523) there was a significant difference (P=0.039). There was quick return to normal values after operation in those that were operated upon to release neurovascular compression. An improvement of 13.44% ± 8.769. Conclusion. NIRS data is shown to be valid in this model. Further studies are needed to delineate the normal values for StO2 and further investigate the indications for intervention. NIRS measurements of muscle tissue oxygenation can identify patients with clinical neurovascular compromise, and can identify the return of adequate perfusion following operative correction of supracondylar fractures. NIRS based tissue oxygenation monitoring may be a useful adjunct to clinical assessment, particularly in paediatric patients and those with altered consciousness


The Bone & Joint Journal
Vol. 102-B, Issue 10 | Pages 1405 - 1411
3 Oct 2020
Martynov I Klink T Slowik V Stich R Zimmermann P Engel C Lacher M Boehm R

Aims

This exploratory randomized controlled trial (RCT) aimed to determine the splint-related outcomes when using the novel biodegradable wood-composite splint (Woodcast) compared to standard synthetic fibreglass (Dynacast) for the immobilization of undisplaced upper limb fractures in children.

Methods

An exploratory RCT was performed at a tertiary paediatric referral hospital between 1 June 2018 and 30 September 2019. The intention-to-treat population consisted of 170 patients (mean age 8.42 years (SD 3.42); Woodcast (WCG), n = 84, 57 male (67.9%); Dynacast (DNG), n = 86, 58 male (67.4%)). Patients with undisplaced upper limb fractures were randomly assigned to WCG or DNG treatment groups. Primary outcome was the stress stability of the splint material, defined as absence of any deformations or fractures within the splint during study period. Secondary outcomes included patient satisfaction and medical staff opinion. Additionally, biomechanical and chemical analysis of the splint samples was carried out.