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East and Central African Journal of Surgery
Association of Surgeons of East Africa and College of Surgeons of East Central and Southern Africa
ISSN: 1024-297X EISSN: 1024-297X
Vol. 18, No. 2, 2013, pp. 94-102
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Bioline Code: js13036
Full paper language: English
Document type: Research Article
Document available free of charge
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East and Central African Journal of Surgery, Vol. 18, No. 2, 2013, pp. 94-102
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Early Outcome of Delayed Management of Supracondylar Humeral Fractures in Children in Rwanda.
Bayisenga, J.; Ssebuufu, R. & Mugenzi, D. S.
Abstract
Background:
Supracondylar fractures of humerus are the most common in children especially in
the first decade of life. They demand proper management to keep functional and cosmetic of the
elbow. The incidence of Lagrange &Rigault stage IV fractures is low among the supracondylar
fractures of humerus. Different modalities of treatment have been proposed and used for this type
of fractures. Among different techniques, the open reduction and fixation with K-wire pinning
method was used for this study. The aim of this study was to evaluate the early outcome of open
reduction and internal fixation with K-wires pinning of Lagrange &Rigault stage IV supracondylar
fractures in children in Rwanda.
Results:
Fifty three cases were recruited and 46 of them have completed the follow up for that
analyzed. The male sex and the left limb were more frequent in this study. The early functional
outcome was studied using the flexion and extension measuring the range of motion and the
anatomical outcome was studied measuring the Bauman’s angles. The combination of both range
of motion and Bauman’s angles gave the Flynn criteria which was conclusive: Excellent 34.8%,
Good 39.1%, Fair 10 (21.7%) and Poor 4.3%. But following the Flynn criteria these results were
grouped into two categories such as satisfactory with 95.7% and unsatisfactory with 4.3%. There
was no influence of delay on the outcome in this study (P-value: 0. 270) while the persistence of
edema on discharge day was however strongly associated with poor outcome measures (p=0.01).
Conclusion:
The results from this study showed that open reduction and internal fixation with Kwires
cross pinning is still effective method to treat Lagrange &Rigault stage IV supracondylar
humerus fractures in children especially in delayed management and in the setting where there is
not intensifier imaging. There are different causes of delay of surgery at each level of health care
delivery in Rwanda, but the delayed management did not increase the rate of complications
following open reduction and internal fixation in Lagrange &Rigault Stage IV supracondylar
humerus fractures in children.
Keywords
Outcome; Delayed Management; Supracondylar; Humeral; Fracture
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© Copyright 2013 - East and Central African Journal of Surgery
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