Kang Seungcheol, Park Soo-Sung
Department of Orthopaedic Surgery, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, South Korea.
J Orthop Trauma. 2015 Aug;29(8):e253-8. doi: 10.1097/BOT.0000000000000322.
Under the hypothesis that the elbow alignment, namely the carrying angle, could predispose individuals to a specific type of pediatric elbow fracture after a fall onto an outstretched arm, we investigated the relationship between radiographic carrying angle and elbow fracture type in children.
Retrospective case-control study.
Level I pediatric trauma center.
PATIENTS/PARTICIPANTS: We reviewed 374 children who were diagnosed with supracondylar fracture (SCF, n = 208), lateral condylar fracture (LCF, n = 132), and radial neck fracture (RNF, n = 34).
The association between the radiographic carrying angle and the fracture type was investigated.
To adjust for bias, 2 statistical methods were used: multivariate analysis using a baseline-category logistic model and a case-matching method using propensity score analysis.
In the multivariate analysis, with SCF patients set as the baseline category, a more valgus-deviated elbow (increased carrying angle, P = 0.011) predisposed individuals to RNF, whereas a more varus-deviated elbow (decreased carrying angle, P < 0.001) predisposed them to LCF. In the case-matched analysis, there were also significant differences in carrying angles between RNF and case-matched SCF patients (14.3 vs. 11.4 degrees, P = 0.013) and between LCF and case-matched SCF patients (7.7 vs. 11.7 degrees, P < 0.001).
Elbow alignment, which may influence the transmission of traumatic force during a fall onto an outstretched elbow, could be a predisposing factor for specific types of pediatric elbow fracture. The results provide the additional information about the injury mechanisms of pediatric elbow fracture and may deepen our understanding of the fractures.
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
基于肘部对线（即提携角）可能使个体在伸直手臂摔倒后易发生特定类型小儿肘部骨折的假设，我们研究了儿童X线提携角与肘部骨折类型之间的关系。
回顾性病例对照研究。
一级小儿创伤中心。
患者/参与者：我们回顾了374例被诊断为肱骨髁上骨折（SCF，n = 208）、外侧髁骨折（LCF，n = 132）和桡骨颈骨折（RNF，n = 34）的儿童。
研究X线提携角与骨折类型之间的关联。
为校正偏倚，使用了2种统计方法：采用基线类别逻辑模型的多变量分析和采用倾向得分分析的病例匹配方法。
在多变量分析中，以SCF患者作为基线类别，肘部外翻更明显（提携角增大，P = 0.011）使个体易发生RNF，而肘部内翻更明显（提携角减小，P < 0.001）使个体易发生LCF。在病例匹配分析中，RNF与病例匹配的SCF患者之间（14.3°对11.4°，P = 0.013）以及LCF与病例匹配的SCF患者之间（7.7°对11.7°，P < 0.001）的提携角也存在显著差异。
肘部对线可能会影响伸直肘部摔倒时创伤力的传递，可能是特定类型小儿肘部骨折的一个易感因素。这些结果提供了有关小儿肘部骨折损伤机制的更多信息，可能会加深我们对这些骨折的理解。
预后III级。有关证据水平的完整描述，请参阅作者须知。
