DISSERTATION SYNOPSIS
1. NAME OF THE CANDIDATE : Dr PHILIP. K. THOMAS
ADDRESS :
POST GRADUATE STUDENT
DEPARTMENT OF ORTHOPAEDICS
ST JOHNS MEDICAL COLLEGE
BANGALORE 34
2. NAME OF THE INSTITUTE : ST. JOHNS MEDICAL COLLEGE
BANGALORE 34
3. COURSE OF STUDY AND
SUBJECT : MS ORTHOPAEDICS
4. DATE OF ADMISSION TO
THE COURSE : 25 TH MARCH 2010
5. TITLE : TO STUDY THE FUNCTIONAL ASSESSMENT FOLLOWING SURGICAL TREATMENT OF TYPE 3 SUPRACONDYLAR HUMERUS FRACTURES IN CHILDREN
.
6 BRIEF RESUME OF THE INTENDED WORK:
6.1 NEED FOR THE STUDY:
Supracondylar fractures of humerus are common fractures seen in children.
There are two types: extension type (95%) & flexion type;
Gartland classification for extension fractures:
- type I: non-displaced fracture
- type II: displaced with intact posterior cortex;
- type III: displaced with no cortical contact;
The need for the study is assess the functional outcome following surgical treatment of Type 3 Supracondylar Humerus fractures , as these fractures are associated with high risk of neurovascular injuries.
6.2 REVIEW OF LITERATURE:
1. Taco Gosens et al ( Injury, Int. J. Care, Sept 2002) 200 cases were studied on Neurovascular complications and functional outcome in displaced
supracondylar fractures of the humerus in children , the functional outcome was 90%. 16.5% had neurological impairment.
2. Ritabh Kumar et al (Jan 2002) studied 44 children with Gartland type3 fracture treated surgically. 8 patients had restriction of elbow motion. According to Flynn`s criteria ,42 patients had a satisfactory outcome.
3. AJ Weiland et al studied 52 cases of displaced supracondylar five patients patients had moderate loss of range of motion , one patient had extension loss of less than 10 degrees & three patients had flexion loss of less than 10 degrees
4. UB Yadav et al(Indian journal of orthopaedics,july 2004) studied 197 cases of Gartland`s type 2 & type3 . assessed by Flynn criteria ,145 had excellent result & 41 good results.
5. Chang-Wug Oh et al (Journal of Orthopaedic Science, ) studied
35 children (mean age 6.4 years) with completely displaced supracondylar fractures of the distal humerus between 1996 and 2000. according to Flynn's criteria, the results were excellent in 18, good in 12, fair in 2, and poor in 3.
6. Mehlman CT et al (Acta Orthop Belg. 1996;) studied 115 patients treated surgically for displaced supracondylar humeral fractures, 89 had type III , ). According to Flynn criteria Eighty-three percent had good or excellent results, 14- had fair results, and 3% had poor results
6.3 OBJECTIVE OF THE STUDY:
1. To know the functional outcome after surgical treatment of about 25 children treated here.
2. To determine the surgical procedure associated with good functional results.
7. MATERIALS AND METHODS:
7.1 Source of Data: Twenty five patients coming to St.John`s Hospital via emergency or Out patient department during the period 2010 -2012 and surgically treated .
Inclusion criteria
Fresh cases of type 3 supracondylar humerus fracture in children below age of 15yrs.
supracondylar humerus fracture associated with neurovascular injury
Exclusion criteria
Supracondylar humerus fractures in adults
Open Supracondylar humerus fractures
Cases lost in follow up.
7.2 Method of collection of data.
From Twenty Five cases of type 3 supracondylar humerus fractures which are surgically treated here in St.Johns . An Observational type of study is done for a minimum period of 3 months and maximum period of 1 year after surgical treatment , data is collected by assessing the patient from date of admission by assessment of function serially during follow up period.
7.3 Does the study require any investigations or interventions to be conducted on patients or other humans or animals ?
No
7.4 Has ethical clearance been obtained from your institution in case of 7.3 ? Approved
1. LIST OF REFERENCES:
1. Dr.Taco Gosens , Karst J. Bongers study on Neurovascular complications and functional outcome in displaced
supracondylar fractures of the humerus in children, Injury, Int. J. Care Injured 34 (2003) 267–273, Accepted 9 September 2002
2. Dr.Ritabh Kumar, E. Krishna Kiran, Rajesh Malhotra, S. Bhan study on Surgical management of the severely displaced supracondylar fracture of the humerus in children, Injury, Int. J. Care Injured 33 (2002) 517–522, Accepted 24 January 2002
3. . Indian journal of Orthopaedics, outcome of Gartland`s type 2 & 3 supracondylar treated by Blount`s technique by Antoine de Gheldere,Damien Bellan .Vol 44,issue 1, Jan – Mar 2010
4. . Omid R ,Choi PD .Skaggs DC Supracondylar humerus fracture in children . Journal of Bone and Joint surgery ,2008, 90:1121-32
5. Dr. AJ Weiland, S Meyer, VT Tolo, HL Berg and J Mueller study on Surgical treatment of displaced supracondylar fractures of the humerus , Journal of Bone Joint Surg Am. 1978;60:657-661
6. . UB Yadav ,R Singhal ,G Tonk, T Aggarwal,AN varma . Indian journal of orthopaedics,july 2004.Volume 38: Number 3:P.166-169
7. Chang-Wug Oh, Byung-Chul Park, Poong-Taek Kim, Il-Hyung Park, Hee-Soo Kyung and Joo-Chul Ihn Journal of Orthopaedic Science Volume 8, Number 2, 137-141, DOI: 10.1007/s007760300023
8. Volkan GURKAN, Haldun ORHUN, Ozan AKCA, Tarcan ERCAN, Sefa OZEL ,Acta Orthop Traumatol Turc 2008;42(3):154-160.
9. French PR. Varus deformity of elbow following S.C. fractures in children. Lancet
1959; 2: 439.
10. Flynn JC, Mathews JG, Benot RL. Blind Pinning of displaced S.C. fractures of
humerus in children. JBJS 1974; 56-A: 263-72.
2. SIGNATURE OF CANDIDATE:
9. REMARKS OF THE GUIDE: Type 3 Supracondylar fracture are rare & it requires a meticulous management , as it is seen in children & it can be associated with neurovascular injury
11. NAME AND DESIGNATION OF:
11.1 GUIDE : Dr. RAMESH L.J,
PROFESSOR,
DEPT. OF ORTHOPAEDICS
ST.JOHNS MEDICAL COLLEGE, BANGALORE
11.2 SIGNATURE:
11.5 HEAD OF DEPARTMENT: DR .SAJI.M.J
PROFESSOR,
DEPT. OF ORTHOPAEDICS ST. JOHNS MEDICAL COLLEGE, BANGALORE
11.6 SIGNATURE:
12.1 REMARKS OF CHAIRMAN AND PRINCIPAL:
12.2 SIGNATURE: