Sahu Ramji Lal
Associate Professor, Department of Orthopaedics, School of Medical Science and Research, Sharda University, Uttar Pradesh, India.
Niger Med J. 2013 Sep;54(5):329-34. doi: 10.4103/0300-1652.122355.
Supracondylar fractures are the commonest elbow injury in children. Most displaced Supracondylar fractures are manipulated and held with a medial/lateral entry or two lateral Kirschner wires. It was the purpose of this study to investigate the treatment of this injury in this unique patient population.
This study was conducted in the Department of Orthopaedic surgery in M. M. Medical College from July 2005 to July 2010. One hundred seventy patients were recruited from Emergency and outpatient department having closed displaced Supracondylar fractures of humerus in children. They were treated either with medial-lateral pin fixation (n = 85) or with 2-lateral pin fixation (n = 85). All patients were operated under general anaesthesia. All patients were followed for 6 months. Results were analysed using Flynn's criteria.
Chi Square Test. Chi Square calculator was used as a software.
All children achieved union in a mean time of 4 weeks (range: 3-6 weeks). Post-operatively, eight patients (4.70%) got ulnar nerve injury and six (3.52%) patients got pin tract infection. Comparison between two groups such as cross K-wire group (85) and lateral K-wire group (n = 85) by using the Chi Square Test showed that in case of 8 weeks with (P-values = 0.89), in 16 weeks (P = 0.91) and 24 weeks (P = 0.85) with respective excellent, good, fair and poor categories were not found statistically significant.
The lateral percutaneous pinning technique of displaced Supracondylar fractures of the humerus offers a viable alternative to the crossed pinning group as it offers the same stability without the incipient risk of iatrogenic ulnar nerve injury.
肱骨髁上骨折是儿童最常见的肘部损伤。大多数移位的肱骨髁上骨折通过内侧/外侧入路或两根外侧克氏针进行手法复位和固定。本研究的目的是调查在这一特殊患者群体中该损伤的治疗方法。
本研究于2005年7月至2010年7月在MM医学院骨科进行。从急诊科和门诊部招募了170例患有儿童闭合性移位肱骨髁上骨折的患者。他们分别接受内侧-外侧钢针固定(n = 85)或两根外侧钢针固定(n = 85)治疗。所有患者均在全身麻醉下手术。所有患者均随访6个月。结果采用弗林标准进行分析。
使用卡方检验。使用卡方计算器作为软件。
所有儿童均在平均4周(范围:3 - 6周)内实现骨折愈合。术后,8例患者(4.70%)发生尺神经损伤,6例患者(3.52%)发生针道感染。通过卡方检验对交叉克氏针组(85例)和外侧克氏针组(n = 85)两组进行比较,结果显示在8周时(P值 = 0.89)、16周时(P = 0.91)和24周时(P = 0.85),各自的优、良、可、差类别在统计学上均无显著差异。
肱骨髁上移位骨折的外侧经皮穿针技术为交叉穿针组提供了一种可行的替代方法,因为它能提供相同的稳定性,且无医源性尺神经损伤的初期风险。