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AAOS issues new clinical practice guideline for treating common elbow fractures in children
Date:11/16/2011

The American Academy of Orthopaedic Surgeons (AAOS) Board of Directors has recently approved and released an evidence-based clinical practice guideline (CPG) on "The Treatment of Supracondylar Humerus Fractures."

Andrew Howard, MD, pediatric orthopaedic surgeon, medical director of the Trauma Program at the University of Toronto Hospital for Sick Children and the chair of the AAOS Work Group responsible for this CPG, said that surgeons see many of these types of fractures, particularly in children ages 5 to 9.

Supracondylar humerus fractures are common and likely occur when children are playing, or while climbing trees, jungle gyms and other structures. When young children fall, they tend to hyperextend their arms. As a result they land on a stiff arm, often fracturing the arm, just above the elbow joint.

In addition to the broken bone, the sheer force of this type of fall, may cause "all kinds of consequences," said Dr. Howard. The artery which provides blood to the forearm and hand runs very close to the elbow, as do the three main nerves of the arm: median, radial and ulnar. As a result, elbow fractures can cause circulation problems, and in 10 to 15 percent of cases, nerve injuries.

This new guideline is the result of a robust review of more than 350 research studies on this topic and includes 14 recommendations on how to stabilize the fracture, remedy circulation problems, and ultimately, ensure the fastest and most comfortable recovery for each child.

Important findings:

  • First, the guideline recommends that surgeons stabilize the fracture with "two or three laterally introduced pins to stabilize the reduction of displaced, misaligned, supracondylar fractures of the humerus."

  • In addition, the guideline recommends procedures to restore blood flow and circulation if the artery has been stretched, torn or severed. Orthopaedic surgeons know that the first thing to do with an arm withou
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Contact: Lauren Pearson
pearson@aaos.org
847-384-4031
American Academy of Orthopaedic Surgeons
Source:Eurekalert

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