Humerus fractures in children: treatment trends and surgical techniques.

Thesis event information

Date and time of the thesis defence

Place of the thesis defence

Leena Palotie Hall (Aapistie 5A). Remote access: https://oulu.zoom.us/j/67255740247

Topic of the dissertation

Humerus fractures in children: treatment trends and surgical techniques.

Doctoral candidate

Medical Doctor Juuli Hannonen

Faculty and unit

University of Oulu Graduate School, Faculty of Medicine, PEDEGO

Subject of study

Pediatric surgery

Opponent

Docent Olli Pajulo, Turku University Hospital

Custos

Professor Juha-Jaakko Sinikumpu, Oulu University Hospital

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Operative treatment of humeral fractures has increased in children

Operative treatment of paediatric proximal humerus and humeral shaft fractures has increased during 21st century. The severity of the fractures did not change and didn’t explain the increase. In addition, the incidences of paediatric proximal humerus, humeral shaft fractures and elbow dislocations did not change.

The other finding of the study was that the operative treatment of distal humerus fractures by lateral-only fixation technique showed satisfactory results. This surgical technique might be unstable, but if the pin configuration followed the recommendation the fixation was stable. Also, this technique is unlikely to cause ulnar nerve damage and no ulnar nerve injury was detected.

Fractures in childhood commonly lead to hospitalisation. The humerus is the second most common bone to break, and the elbow is the most common joint to dislocate in children. Distal humerus fractures require operative treatment often and there’s several different techniques to perform.

The role of the upper extremity is important in everyday activities and a child’s humeral fracture might cause long-term discomfort for the whole family. Operative treatment may be scary for a child but is sometimes required. Impatience shouldn’t lead to the selection of operative treatment, even though the conservative treatment requires more follow-up visits.

The aim of this doctoral thesis was to study recent trends in the incidence and treatment of paediatric proximal humerus and humeral shaft fractures. Another aim was to analyse stability and technical issues in the lateral-only fixation method of distal humerus fractures.

The population-based retrospective study cohort was collected between 1996–2015 from the databases of Oulu University Hospital. The study population composed of 0- to 15-year-old children and adolescents. Treatment trends, changes in fracture incidences and treatment outcomes in the cohort were analysed. The Statistics Finland database was used to define incidences.
Last updated: 3.12.2021