Ponce Brent A, Hedequist Daniel J, Zurakowski David, Atkinson Carol C, Waters Peter M
Harvard Combined Orthopaedic Surgery Program, Massachusetts General Hospital, Boston, Massachusetts 02115, USA.
J Pediatr Orthop. 2004 Nov-Dec;24(6):610-4. doi: 10.1097/00004694-200411000-00002.
The purpose of this study was to evaluate the need for clinical evaluation with radiographs within 10 days of closed reduction and percutaneous pinning for the treatment of displaced supracondylar humerus fractures. Between May 1 and December 31, 2001, the authors evaluated the complications with closed reduction and percutaneous pinning of 104 displaced supracondylar humerus fractures. Fifty-two of the patients had the initial follow-up examination with radiographs 10 days or less after pinning; the other 52 patients had the initial follow-up examination with radiographs either after 10 days or on the day of pin removal. The overall complication rate for the series was 7.7% (8/104). All eight complications were in type III fractures. The early follow-up group had six complications; the late follow-up group had two complications. Baumann's angle, lateral humerocapitellar angle, and lateral rotational percentage were not significantly different between the two groups. The only variable tested that was associated with a complication was pin configuration. No association between late follow-up and complications was identified. The authors conclude that clinical and radiographic evaluation of routine displaced supracondylar humerus fractures requiring closed reduction and percutaneous pinning may be safely delayed until pin removal.
本研究的目的是评估对于移位性肱骨髁上骨折,在闭合复位和经皮穿针固定治疗后10天内进行X线片临床评估的必要性。2001年5月1日至12月31日期间,作者评估了104例移位性肱骨髁上骨折行闭合复位和经皮穿针固定后的并发症情况。其中52例患者在穿针后10天或更短时间内进行了首次X线片随访检查;另外52例患者在10天后或拔针当天进行了首次X线片随访检查。该系列的总体并发症发生率为7.7%(8/104)。所有8例并发症均发生在III型骨折中。早期随访组有6例并发症;晚期随访组有2例并发症。两组之间的鲍曼角、肱骨小头外侧角和外侧旋转百分比无显著差异。唯一与并发症相关的检测变量是穿针构型。未发现晚期随访与并发症之间存在关联。作者得出结论,对于需要闭合复位和经皮穿针固定的常规移位性肱骨髁上骨折,临床和X线片评估可安全延迟至拔针时进行。