pelvic fractures in elderly patients often result in poor prognosis due to immobilization associated complications. Thus, the target of the treatment in this patient group is early mobilization in order to reduce the risk of these complications. We report outcomes of 4 cases of pelvic fracture in elderly patients, who were treated with percutaneous screw fixation. We examined medical records and images of 4 elderly patients between January 2012 and May 2012 in our center. Mean age of the patients was 88.8 years old (range 86–92 years). The causes of injury were motor vehicle accident in 3 patients, and a fall in 1 patient. Fracture types were ao type a in 1 patient, type b in 2 patients and type c in 1 patient. Mean injury severity score was 25 (10–57). We assessed functional status after the follow-up period using majeeds grading score for pelvic fractures.Background
Material and method
In 1980, we developed a specially designed brace for treating supracondylar fractures of the humerus in children, along with an easy and safe technique of reduction by skeletal traction. This method, which takes into consideration only the medial tilting and anterior angulation of the distal fragment, achieves complete reduction, ignoring any lateral, posterior and minor rotational displacements of the fragment. Skeletal traction is applied through a screw inserted into the olecranon and the angulation at the fracture site is reduced regardless of the anatomical position without manipulation. We treated 193 children with displaced supracondylar fractures of the humerus using this method between 1980 and 2001. Only four children (2%) developed cubitus varus. The majority obtained an excellent range of movement at the elbow; one had a 25° limitation of flexion. This technique is an effective and easy method of treating supracondylar fractures of the humerus in children.
The purpose of this study is to introduce our treatment by skeletal traction in brace and to report the safety and easiness of this method and low incidence of cubitus varus. In 1980 we developed a specially designed brace for treating the supracondylar fracture, along with a technique of spontaneous reduction by skeletal traction to develop an easy and safe treatment. The brace is made of plastics and aluminum alloy that are radiolucent. The humeral slide bar with attached axillary pad can be moved up and down to adjust the height of the upper arm for each patient. From 1980 to 1999 we have treated 190 children with displaced supracondylar fracture of the humerus. Their ages ranged from 2 to 14 years old and average of age was 7 years old. The fractures occurred most frequently between the ages of 5 to 6. More boys than girls were injured and the left elbow were more often than the right. Among 190 cases, severely displaced cases were most common. (64%) and moderate case 20%, mild case 16%. The period of follow up was 6 months to 11 years, mean 4 years. Placing the arm in the brace with the elbow flexed at right angle, unstable fracture site will be stabilized first. Skeletal traction is performed by a spring through the winged screw. The traction is maintained for three to four weeks. Spontaneous reduction of the displaced fragment can be expected and we emphasize that any manipulative technique is not performed during the treatment at all. Among 190 patients, cubitus varus occurred in only 3 (1.6%) cases because of technical failure. All patients except one obtained excellent functional results, one had 25 degrees of limitation of the elbow flexion. There were no vascular problems or Volkmann’s contracture and ectopic ossification. The results were satisfactory. Our treatment utilizing the brace and skeletal traction for supracondylar fracture of the humerus in children is safe and effective in preventing cubitus varus.
