Classic Trauma Articles

Article 1:

Scannell BP, Jackson JB 3rd, Bray C, Roush TS, Brighton BK, Frick SL. The perfused, pulseless supracondylar humeral fracture: intermediate-term follow-up of vascular status and function. J Bone Joint Surg Am. 2013 Nov 6;95(21):1913-9.

The treatment algorithm for pink, pulseless hands associated with supracondylar humerus fractures remains slightly controversial, with most experts continuing to recommend close observation. This study, from Carolinas Medical Center, asked what happened to 20 patients with perfused, pulseless supracondylar humerus fractures with intermediate term follow up averaging 20 months. All had palpable radial pulses. Duplex ultrasound showed 14 had patent brachial arteries, 5 had occluded arteries, and 1 had arterial stenosis. There were no growth disturbances of the arms, and function was graded as good to excellent in all patients. This study supports the argument that pulseless but perfused supracondylar humerus fractures can be treated with observation, even in patients with actual brachial artery injuries.

Article 2: 

Moroz LA, Launay F, Kocher MS, Newton PO, Frick SL, Sponseller PD, Flynn JM. Titanium elastic nailing of fractures of the femur in children. Predictors of complications and poor outcome. J Bone Joint Surg Br. 2006 Oct;88(10):1361-6.

This article describes the results of a multi-center study on the outcomes of titanium elastic nailing in the treatment of femur fractures in children. Age above 11 and weight more than 49 kg was reported to increase the risk of failure after treatment with titanium elastic nails.

Article 3:

Ramseier LE, Janicki JA, Weir S, Narayanan UG. Femoral fractures in adolescents: a comparison of four methods of fixation. J Bone Joint Surg Am. 2010 May;92(5):1122-9

This article reports the results of four different methods of fixation for femur fractures in adolescents. External fixation was associated with the highest rate of complications.

Article 4:

 Samora JB1, Klingele KE, Beebe AC, Kean JR, Klamar J, Beran MC, Willis LM, Yin H, Samora WP. Is there still a place for cast wedging in pediatric forearm fractures? J Pediatr Orthop. 2014 Apr-May;34(3):246-52.

Loss of reduction is common after treatment of displaced forearm fractures in children. This article reports the successful use of cast wedging in the treatment of forearm fractures. The successful use of cast wedging can prevent surgical treatment in this group of patients.

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