Executive Editor: Fergal Monsell General Editor: Chris Colton

Authors: Andrew Howard, Theddy Slongo

Pediatric distal humerus 13-M/3.1 III and IV External fixator

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Glossary

Postoperative care

This fixation is sufficiently stable to permit early movement and daily activities. Additional immobilization with a plaster cast or splint is not required.

If the child remains for some hours/days in bed, the elbow should be elevated on pillows to reduce swelling and pain.

See also the additional material on postoperative infection and compartment syndrome.

The postoperative protocol is as follows:

  • Early postoperative clinical documentation is undertaken
  • If  postoperative x-ray control shows unsatisfactory alignment, this can be adjusted, usually without further anesthesia
  • Pin care according to local practice
  • According to the level of pain, early movement of the elbow should be encouraged
  • Discharge from hospital according to local practice (1-3 days)
  • First clinical and radiological follow-up is, depending on the age of the child, usually 4-5 weeks postoperatively
  • In most cases, the child is able to move the elbow almost fully at this first check-up
  • Physiotherapy is normally not indicated

Removal of external fixator

Removal of the external fixator is undertaken according to local practice (sedation/local anesthesia, short anesthesia, or N2O2) after the first x-ray control provided fracture healing is seen.

v1.0 2016-12-01