Parikh Shital N, Jain Viral V, Youngquist Jeffrey
Division of Pediatric Orthopaedic Surgery, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, MLC 2017, Cincinnati, OH 45229, USA.
Orthopedics. 2013 Jun;36(6):783-8. doi: 10.3928/01477447-20130523-25.
The purpose of this retrospective case control study was to evaluate the results of intrafocal pinning for distal radius metaphyseal fractures in children and to compare these results with conventional pinning. Data were collected from medical records and radiographs from patients who underwent closed reduction and percutaneous pinning for distal radius fracture in a Level I trauma center at the authors' institution between 2008 and 2010. Inclusion criteria included a dorsally angulated metaphyseal fracture without physeal involvement, an open distal radius physis, and a follow-up to radiographic union. A total of 10 patients with intrafocal pinning were compared to 26 patients with conventional pinning. Preoperatively, angulation was greater in patients who received intrafocal pinning than conventional pinning based on anteroposterior radiographs. Postoperatively, the 2 groups did not differ in angulation on either anteroposterior or lateral radiographs. One malunion and 2 pin-related complications occurred in the conventional pinning group, and 1 pin-related complication occurred in the intrafocal pinning group. The 2 groups did not differ by age, sex, side of injury, days to surgery, or initial shortening. This study affirms that the intrafocal pinning technique is an alternative to the conventional pinning technique for the stabilization of displaced metaphyseal distal radius fractures in children. Intrafocal pinning can also be used as a reduction tool for fractures that cannot be reduced by closed manipulation. The complications are comparable between the 2 techniques.
这项回顾性病例对照研究的目的是评估儿童桡骨远端干骺端骨折的病灶内穿针固定结果，并将这些结果与传统穿针固定进行比较。数据收集自2008年至2010年在作者所在机构的一级创伤中心接受桡骨远端骨折闭合复位和经皮穿针固定的患者的病历和X光片。纳入标准包括无骨骺受累的背侧成角干骺端骨折、开放性桡骨远端骨骺以及随访至影像学愈合。将10例采用病灶内穿针固定的患者与26例采用传统穿针固定的患者进行比较。术前，根据前后位X光片，接受病灶内穿针固定的患者的成角大于传统穿针固定的患者。术后，两组在前后位或侧位X光片上的成角没有差异。传统穿针固定组发生1例畸形愈合和2例与针相关的并发症，病灶内穿针固定组发生1例与针相关的并发症。两组在年龄、性别、受伤侧、手术天数或初始缩短方面没有差异。本研究证实，病灶内穿针固定技术是儿童移位性桡骨远端干骺端骨折稳定固定的传统穿针固定技术的替代方法。病灶内穿针固定也可作为闭合手法无法复位的骨折的复位工具。两种技术的并发症相当。
