Ankara Training and Research Hospital, Ulucanlar, Ankara, Turkey.
Bone Joint J. 2013 Apr;95-B(4):563-7. doi: 10.1302/0301-620X.95B4.31143.
Redisplacement is the most common complication of immobilisation in a cast for the treatment of diaphyseal fractures of the forearm in children. We have previously shown that the three-point index (TPI) can accurately predict redisplacement of fractures of the distal radius. In this prospective study we applied this index to assessment of diaphyseal fractures of the forearm in children and compared it with other cast-related indices that might predict redisplacement. A total of 76 children were included. Their ages, initial displacement, quality of reduction, site and level of the fractures and quality of the casting according to the TPI, Canterbury index and padding index were analysed. Logistic regression analysis was used to investigate risk factors for redisplacement. A total of 18 fractures (24%) redisplaced in the cast. A TPI value of > 0.8 was the only significant risk factor for redisplacement (odds ratio 238.5 (95% confidence interval 7.063 to 8054.86); p < 0.001). The TPI was far superior to other radiological indices, with a sensitivity of 84% and a specificity of 97% in successfully predicting redisplacement. We recommend it for routine use in the management of these fractures in children.
再移位是儿童前臂骨干骨折用石膏固定治疗最常见的并发症。我们之前已经表明，三点指数（TPI）可以准确预测桡骨远端骨折的再移位。在这项前瞻性研究中，我们将该指数应用于儿童前臂骨干骨折的评估，并将其与可能预测再移位的其他与石膏相关的指数进行比较。共纳入 76 名儿童。分析了他们的年龄、初始移位、复位质量、骨折部位和水平以及 TPI、坎特伯雷指数和填充指数的石膏质量。使用逻辑回归分析探讨再移位的危险因素。共有 18 例（24%）骨折在石膏中再移位。TPI 值>0.8 是再移位的唯一显著危险因素（优势比 238.5（95%置信区间 7.063 至 8054.86）；p<0.001）。TPI 远优于其他影像学指数，在成功预测再移位方面具有 84%的敏感性和 97%的特异性。我们建议在儿童这些骨折的常规管理中使用。
