Good evening dear friends of the community. This time I want to tell a new story that recently happened to me, I actually happened to my little daughter. It was a fracture in the left arm elbow and here I tell my story:
On Saturday, August 19, I was on duty at the hospital, when I received a call from my mother in the afternoon, her voice was broken, with tears and desperation, she said to me: "My daughter Valerie had an accident" and I asked, "What happened, Mom?" and I did not understand what he was saying to me because I could not decipher his words in such desperation, I told him to calm down and tell me what happened to the girl, and he said: "I fell down and broke my arm and feel a lot pain, "my father was out of town and could not find her to bring her to the hospital, so it was a coincidence and Valerie's father was visiting and he was able to go get her and take her, so that the girl received prompt medical attention. On the way to the hospital, my mother told me that Valerie had a lot of signs of pain, she kept crying and crying. As soon as I got there, I noticed her arm. At first I thought it was just a dislocation in her left arm. It's nothing serious thank God. "
Immediately we went to the area of traumatology, where it was attended by one of my colleagues, and with the x-rays of the arm and elbow taken, he realized that it was a Supracondilea Fracture of Left humerus and that his treatment consisted of an emergency surgical intervention . And of course we live in a Venezuela where the emergencies wait, and for that day then only took the arm to its place and placed an immobilization type splint prior placement sedation as the pain and cries of my little girl were huge, already made the correction that could be done at that moment we decided to place analgesia and take it home to later plan such intervention.
That weekend was preceded to perform all the pre-operative. On Monday 21, he was taken to the specialist doctor's office who was on duty that day, who kindly received us and confirmed the importance of carrying out the surgical procedure by Friday 25 at 8 am, as long as we had to disposition all the materials requested to carry out the intervention, which as well know in Venezuela the hospitals no longer have supplies and runs on the part of the patient's relatives to be able to provide the implements requested from the doctors. Which was quite difficult for me to be able to get them, due to the scarcity of these medical supplies and the high prices.
The nerves and anxiety of that day are indescribable to see my little girl in her surgical gown her bonnet and just wait to see her sleep until they took her to the chirofano, since being her mother I can not enter that intervention, it was the minutes Longer in my life, to see the one to leave and tell me that everything went well was a huge relief. Although I woke up very painful for my little girl, everything went well, for now it is in recovery and in medical treatment, waiting and thanking God for everything to come out well until now.
The operation was a success, after approximately an hour of waiting, the doctor leaves the room of chirofano and tells me that everything was as I planned, that although I was astonished to see the bone totally discarded, I perform a great work to rebuild it and the girl can have normal mobility of her arm.
The x-rays of my princess after the operation.
But they wonder what is a Supracondilea Fracture of Left Humer ??.
They represent the second most frequent lesion in children aged 3 to 10 years, reaching their highest incidence rate at 7 years, being more common in men and in the left arm, this type of fracture is only surpassed in frequency by the distal fracture of radius.
https://www.flickr.com/photos/yoyigrande/13102860295
Mechanism of production of this type of fracture.
By extension and flexion; more frequent in 95% of cases and occurs when the child falls with the palm of the hand and elbow in hyperextension, while the flexion fracture occurs when the child falls on the elbow that is in flexion.
How are these fractures classified?
The classification of the fractures in extension more used today, is the one proposed by Gartland and son;
A.- Type I: not displaced
B.- Type II - displaced but with posterior cortical intact
C. - Type III - displaced with loss of contact of the posterior cortex, these are subdivided into type III-A when the displacement is posteromedial and III-B when it is posterolateral.
Symptom.
Pain, enlargement of the entire elbow region and difficulty in the elbow's motion; the pain increases with passive mobility and external pressure.
Signos.
Increased volume due to edema (which varies in intensity depending on the degree of displacement of the fracture and its evolution time); deformity of the region due to both the edema and the displacement of the fracture.
Diagnosis.
X-rays are necessary. These will establish what type of fracture occurred and whether the bones moved from their place.
Treatment.
Treatment depends on the type of fracture and the degree of displacement. The term displacement refers to the distance that the broken ends of the bones were separated.
NON-Surgical Treatment: If the displacement is very small or there is no displacement, the physician can immobilize the arm in a cast or splint for 3 to 5 weeks. During this time, another x-ray may be necessary to determine if the bones remain properly aligned.
Surgical Treatment: If the fracture forced the bones out of alignment, the doctor should manipulate them to return them to their place. Sometimes this can be done without surgery, but more often surgery will be needed. Nails, screws, or wires are used to hold the bones in place.
The child should wear a cast for several weeks before the nails are removed. Range-of-motion exercises can usually start about a month after surgery.
Already a month ago of this fracture my daughter has had a very good recovery stage, last Friday she was removed stitches of the suture of the operation and plaster that immobilized the arm. The wires will still remain for the next two weeks until they loosen, since the bone will be fully welded and it will not be necessary to continue having the wires to support the bone.
These two weeks will be hard treatment, performing a series of exercises so that the arm can have normal movement before the fracture and it does not become rigid. The therapy will be based on the next two months, with different scales, each one more intense than the previous one, with the favor of God everything will turn out well and my daughter will have the normal life as before.
Credits:
http://orthoinfo.aaos.org/topic.cfm?topic=a00488
http://www.medigraphic.com/pdfs/orthotips/ot-2009/ot093c.pdf
http://sogacot.org/Documentos/FracturasExtremoDistalHumero.pdf
Thank you very much for reading my story, it was very nice for me to share it with you all
bY Johana Albarran
Doctor