Elbow Injury in Pediatric Patients

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About this Research Topic

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Background

Active participation in sports arouses the concern of pediatric elbow fractures in recent years. Although guidelines have been established for the treatment of most of the common fractures, there is still controversy over many specific points that may influence the decision-making process in clinical practice. With an increasing number of evidence, surgeons may also have new consensus.

As the most common elbow fracture, supracondylar fracture of the humerus has been extensively investigated by orthopediatricians. However, severe cases, such as type IV supracondylar fractures and metaphyseal-diaphyseal junction fractures, remain challenging due to the difficulty to achieve satisfactory stability. This has brought about different fixation techniques for those fractures and no consensus has been reached as to the best choice. Meanwhile, for mild cases, whether to perform a Closed Reduction and Percutaneous Pinning (CRPP) is a great concern to doctors and guardians. A proper decision depends on the accurate prediction of risk factors and adequate anticipation of long-term outcomes. Similar problems also exist in lateral condylar fractures. That is why we need more clues to back up the decision-making and the selection of fixations.

Another point of concern is about the Monteggia fracture, the patho-anatomical basis of which partly lies in the annular ligament injury. Most Monteggia fractures could be treated by CRPP, leaving the injured annular ligament untreated. So, we are concerned about how those ligaments were injured and what the long-term outcome would be for those untreated injuries. From this, we extend our interest to other peri-elbow ligament injuries, which might cause significant discomfort. This has always been a concern for adult patients but was only noticed for several years in pediatric patients. Therefore, we need some overall and detailed introduction to those circumstances.

For this Research Topic, we would like to bring together recent advances on elbow injury in pediatric patients. The prediction of stability for lateral condylar fractures of the humerus. It would be very practical if the stability of the fracture site can be accurately assessed in X-ray films. Theoretical basis and clinical evidence for the selection of fixation in challenging types of elbow fractures are needed, such as type IV supracondylar fractures and metaphyseal-diaphyseal junction fractures. Detailed descriptions of annular ligament injury would be very helpful in the pre- and post-operative assessment of Monteggia fractures.

We welcome submissions of Original Research and Review articles focusing on, but not limited to, the following aspects:
• Pre-operative assessment and decision-making for lateral condylar fractures of the humerus;
• Alternative treatment (other than Kirschner wire fixation) for type IV supracondylar fractures and metaphyseal-diaphyseal junction fractures;
• The anatomical basis and evaluation of the annular ligament injury in Monteggia fractures;
• Mini-invasive surgical techniques for peri-elbow fractures;
• Updates on peri-elbow ligament injuries (e.g. posterio-lateral rotational instability).

Keywords: Humeral Fracture, Radial Fracture, Ulnar Fracture, Elbow Injury, Pediatric

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