Nerve Examination, Supracondylar Humerus Fractures
Conditions
Keywords
Supracondylar humerus fracture, Nerve examination, Rock-Paper-Scissors-Ok
Brief summary
Patients presenting to the Orthopedics and Traumatology Clinic of Ankara Bilkent City Hospital with supracondylar humerus (elbow) fractures will initially undergo closed reduction. Following the reduction procedure, radiographic imaging will be obtained and patients will be re-evaluated. If surgical intervention is deemed necessary based on this assessment, operative treatment will be recommended. The surgical technique will consist of closed reduction followed by percutaneous Kirschner wire (K-wire) fixation. In cases where adequate fracture reduction cannot be achieved by closed means, open reduction will be performed through an anterior incision. In these patients, K-wires will again be inserted percutaneously. Fixation will be achieved using one medial (ulnar side) and two lateral K-wires. Postoperatively, a neurological examination will be performed. In patients who are shown a video and taught the game beforehand, neurological assessment will be conducted using the "rock-paper-scissors" game. In other patients, the examination will be performed by demonstrating and requesting specific hand movements. If ulnar nerve deficit is detected during postoperative neurological evaluation, the medial K-wire will be removed. The time interval between the patient's emergence from anesthesia and the neurological examination will be recorded.
Interventions
OTHERConventional Neurological Examination
Standard neurological examination performed by the clinician using conventional bedside assessment.
OTHERPreoperative video-based training module
Participants in the smartphone-assisted group viewed a single standardized preoperative video-based training module delivered via YouTube (duration: 2 minutes 34 seconds).
Sponsors
Ankara City Hospital Bilkent
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
4 Years to 10 Years
Healthy volunteers
No
Inclusion criteria
* Children aged 4 to 10 years * Underwent surgical treatment for supracondylar humerus fracture * Willing to participate (assent/parental consent as applicable)
Exclusion criteria
* Cognitive inability to understand or perform the rock-paper-scissors-OK movements * Declined participation (patient and/or parent/guardian refusal, as applicable)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative neurological examination duration (minutes) | Immediately postoperatively after awakening in the recovery room | Time required to complete the neurological examination postoperatively, recorded in minutes. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Preoperative neurological deficit (yes/no) | Preoperatively in the emergency department (before surgery) | Presence of neurological deficit on examination (radial, ulnar, median, and anterior interosseous nerve function). Recorded as yes/no (frequency, %). |
| Preoperative neurological examination duration (minutes) | Preoperatively in the emergency department (before surgery) | Time required to complete the neurological examination preoperatively, recorded in minutes. |
| Patient/parent satisfaction: Child Hospital Consumer Assessment of Healthcare Providers and Systems (Child HCAHPS) | On the day the patients is discharged after surgery (typically the 2nd or 3rd day after the operation) | Satisfaction was measured with the Child Hospital Consumer Assessment of Healthcare Providers and Systems (Child HCAHPS). Domain scores were calculated as mean values on a 1-4 Likert scale (min=1, max=4); higher scores indicate better satisfaction/better care experience. |
| Postoperative neurological deficit (yes/no) | Immediately postoperatively after awakening in the recovery room | Presence of neurological deficit on examination (radial, ulnar, median, and anterior interosseous nerve function). Recorded as yes/no (frequency, %). |
Countries
Turkey (Türkiye)
Outcome results
None listed