Complications and difficulties due to bonesetter in the treatment of pediatric distal humerus fractures
Keywords:Neurovascular injury, supracondylar humerus fracture, traditional bonesetter
Objective: In this study, cases with delayed diagnosis and treatment due to traditional bonesetters were examined and in this article, we aimed to address the problems experienced by patients with supracondylar humerus fractures who were exposed to traditional bonesetters intervention and the physicians who treat these patients.
Materials and Methods: Thirty-six patients with supracondylar humerus fractures who were admitted to our hospital between January 2017 and December 2020 and were accepted as bonesetters sequelae were retrospectively reviewed. The time between injury and admission to the hospital, skin problems, neurovascular examinations, and soft tissue conditions of the patients were evaluated. The operation time, open or closed reduction, and fixation technique were examined.
Results: The mean time between fracture and admission to the hospital was 5.28 days (1-15 days). After the patients were admitted to the hospital, their surgeries were delayed due to edema or skin problems and delayed an average of 15.4 hours (5-48 hours). The mean operative time was 96.3 minutes (38-221 minutes), and 19 patients (52.8%) required open reduction. The mean hospital stay of the patients was 3 days (2-11 days). In the pre-operative evaluation, nerve lesion was detected in 6 patients (16.7%). It is remarkable that the number of patients who applied to our hospital after bonesetters applied in 2020, has increased significantly.
Conclusions: The application of bonesetters in children with fractures around the elbow causes a delay in the arrival of patients to the hospital and causes increased complications. The number of applications for bonesetters increased significantly in 2020 due to both the pandemic restrictions and the patients' avoidance of applying to the hospital during the COVID-19 pandemic. Edema and skin lesions as to dislocation sequelae affect the timing of Surgery.
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