Department of Pediatric Orthopedics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
J Orthop Trauma. 2014 Jun;28(6):354-9. doi: 10.1097/BOT.0000000000000015.
The purpose of this study was to report the efficacy of the Kapandji technique performed in the prone position for humeral supracondylar fractures in children.
Retrospective.
Level I trauma center.
PATIENTS/PARTICIPANTS: We retrospectively reviewed 34 children with Gartland type III supracondylar humerus fractures. There were 22 boys and 12 girls with a mean age of 5.2 years (range, 1-12.7 years).
Closed reduction and the Kapandji technique were performed in the prone position for all patients. The mean follow-up was 17.4 months (range, 13.2-24.8 months).
We assessed preoperative and postoperative radiographs to evaluate the quality of the reduction. The clinical outcome was assessed according to the criteria of Flynn.
All operations were performed in a closed manner, no cases required open reduction. Loss of reduction after K-wire fixation was identified in 2 patients. There were no pin-related nerve injuries. The mean range of elbow motion was 139.6 degrees. The clinical outcome was excellent in 31 patients, good in 2 patients (97% excellent or good), and fair in 1 patient.
This technique is an effective and safe option to treat type III supracondylar humerus fractures in children. In patients with severe soft tissue swelling, unstable fracture reduction, or unable to achieve acceptable reduction, this technique could facilitate fracture reduction and avoid unnecessary open reduction. The disadvantage of this technique is that the prone position is less desirable for airway management.
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
本研究旨在报告俯卧位 Kapandji 技术治疗儿童肱骨髁上骨折的疗效。
回顾性研究。
一级创伤中心。
患者/参与者：我们回顾性分析了 34 例 Gartland Ⅲ型肱骨髁上骨折患儿。男 22 例，女 12 例，平均年龄 5.2 岁（1~12.7 岁）。
所有患者均行闭合复位及俯卧位 Kapandji 技术治疗。平均随访 17.4 个月（13.2~24.8 个月）。
我们评估术前和术后 X 线片，以评估复位质量。临床结果根据 Flynn 标准进行评估。
所有手术均在闭合状态下进行，无 1 例需要行切开复位。2 例患者在克氏针固定后出现复位丢失。无针相关神经损伤。平均肘关节活动范围为 139.6°。31 例患者临床结果优良，2 例患者良好（97%为优良），1 例患者可。
对于儿童Ⅲ型肱骨髁上骨折，该技术是一种有效且安全的治疗方法。对于软组织肿胀严重、骨折复位不稳定或无法获得可接受复位的患者，该技术有助于复位，避免不必要的切开复位。该技术的缺点是俯卧位不利于气道管理。
治疗性 IV 级。有关证据水平的完整描述，请参见作者须知。
