• Clinics in Shoulder and Elbow
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• v.5 no.2
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• pp.102-109
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• 2002

Purpose: To evaluate the results of the treatment of the supracondylar fractures of the humerus according to the fixation methods in adults Materials and Methods: Seven patients, aged 55 to 52 years (average,69 years), were reviewed after a mean follow-up of 37 months (range, 11-65 months). According to AO classification all fractures were classified as type A2 (simple transverse supracondylar fracture). Six patients underwent closed reduction and one patient, open reduction after failure of closed reduction. Percutaneous fixation with cannulated screws was performed to the 4 patients, per- cuta)leous fixation with Kirschner wires in 3 patients. All except one patients have associated medical problems. The results were assessed based on the Mayo Elbow Performance Score. Results: All the patients with cannulated screw fixation had stable bony union with excellent ranges of motion (mean: 5-125 degrees). All the three patients who received percuatnaous smooth K-wire fixation had nonunion with poor results, one of them had changed into cannulated screw. and then had good result. Conclusion: Although simple supracondylar fracture is similar to the pediatric fracture in nature, it should be firmly fixed with the method such as threaded cannualted screw rather than the simple fixation with K-wires.

• Clinics in Shoulder and Elbow
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• v.1 no.1
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• pp.58-65
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• 1998

Cubitus varus deformity after supracondylar fracture of the humerus in children generally includes deformities of varus, hyperextension and internal rotation. Recently almost all corrective osteotomies for treatment of the varus deformity have been limited to correction of only the varus or of the varus and hyperextension deformity. Electromyographic study has revealed unphysiological joint motion and muscle activity around the joint in elbows with cubitus varus, hyperextension and internal rotation deformity. On this basis we have successfully attempted simultaneous correction of all three deformities. The end results in ] 3 elbows have been satisfactory without any complications such as delayed union, limitation of elbow motion or nerve palsy. In conclusion, we recommend simultaneous correction of the three elements of cubitus varus deformity to restore anatomic alignment of the elbow joint.

• Journal of Yeungnam Medical Science
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• v.10 no.2
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• pp.400-408
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• 1993

During the period from March 1990 to November 1993, 22 children with diplaced supracondylar fracture of humerus were treated by closed reduction and percutaneous K-wire fixation at department of Orthopaedic surgery in Yeungnam University. All fracture were treated with closed reduction under the general anesthesia and percutaneous pinning. After the fracture was internally fixed, intraoperative anteroposterior reontgenograms of each distal humerus were compared. Only anatomical reduction ensured good result, because the main cause of late cubitus varus was medial tilting of distal fragment. We could follow up 10 patients more than one year. By Flynn's criteria, satisfactory result were obtained in 9 of the 10. Unsatisfactory one had a limitation in flexion of elbow joint, but had no problem in cosmetic feature. In short term follow up of 7 patients, 5 patients had a satisfactory result, too. There were no neurovascular complication and hospitalization was shortened to 11.4 days. Closed reduction and percutaneous pinning provided stabillity, vascular safety, simplified management, reduced hospital stay. This is safe and reliable technique for obtaining and maintaining an excellent reduction.

• Clinics in Shoulder and Elbow
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• v.19 no.4
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• pp.229-236
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• 2016

Background: Cubitus varus and cubitus valgus deformities are common complications of distal humeral fractures in children. We evaluated the usefulness of supracondylar dome osteotomy as a treatment option for adults with cubitus varus or valgus deformity developed during childhood. Methods: Ten patients who had received supracondylar dome osteotomy and stabilization with plates to treat cubitus varus or valgus deformity between July 2006 and August 2013 were included in this study. Their mean age at the time of surgery was $36.50{\pm}10.22years$. The mean follow-up duration was $54.80{\pm}32.50months$. We evaluated humerus-elbow-wrist angles (HEWA), improvements in the lateral prominence index (LPI) or medial prominence index (MPI), Mayo elbow performance scores (MEPS), and overall results in accordance with the Banerjee criteria. Results: For the six patients with cubitus varus, the mean postoperative HEWA, mean correction angle, and mean improvement in LPI were $9.72^{\circ}{\pm}3.95^{\circ}$, $27.67^{\circ}{\pm}10.75^{\circ}$, and $6.92%{\pm}3.40%$, respectively. For the four patients with cubitus valgus, the mean postoperative HEWA, mean correction angle, and mean improvement in MPI were $14.73^{\circ}{\pm}2.97^{\circ}$, $11.55^{\circ}{\pm}3.26^{\circ}$, and $11.33%{\pm}6.39%$, respectively. There was no significant difference between postoperative and preoperative mean MEPS. The subjective ulnar nerve symptoms were alleviated in all patients. The overall results were excellent in six and good in four patients. Conclusions: This study suggests that supracondylar dome osteotomy with secure fixation using double plates may be useful in correcting cubitus varus or cubitus valgus deformity, yielding good functional outcomes in adults.

• Clinics in Shoulder and Elbow
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• v.2 no.2
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• pp.209-213
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• 1999

It is well known that tardy ulnar nerve palsy occurs with cubitus valgus deformity as a late complication after a nonunion of lateral condyle fracture of the humerus in childhood. On the other hand, cubitus varus deformity often results from malunion of supracondylar fractures of the humerus. However, reports of tardy ulnar nerve palsy in cubitus varus deformity are few. We report a patient with bilateral cubitus varus deformities with bilateral tardy ulnar nerve palsy which was confirmed with EMG. She was treated by step cut osteotomy(DeRosa and Graziano) with sub­cutaneous anterior transposition of ulnar nerve.

• Archives of Reconstructive Microsurgery
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• v.19 no.2
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• pp.93-96
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• 2010

We report a case of 44 years old male patient with neuroma-in-continuity of ulna nerve. In the patient's past history, he had received operative treatment for the open supracondylar fracture of right distal humerus and ulnar nerve injury at 10 years ago, and neurolysis was tried 2 times due to severe neuropathic pain. Despite of these operations, the symptom was not improved. In operative field, we noticed neuroma-in-continuity and decided to resect the neuroma until normal nerve fascicle was noted. The nerve cable graft was done with auto sural nerve on the defect site and the nerve was wrapped with small saphenous vein. At post operative 7 months, pain was markedly decreased and sensory recovery was slightly improved and patient was satisfied with the result.