Chen Tony Lin-wei, He Chang-qiang, Zheng Ting-qu, Gan Yan-qun, Huang Ming-xiang, Zheng Yan-dong, Zhao Jing-tao
aThe First Clinical Medical College, Guangzhou University of Chinese Medicine bThe First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangdong, People's Republic of China.
J Pediatr Orthop B. 2015 Sep;24(5):389-99. doi: 10.1097/BPB.0000000000000196.
To compare the biomechanical stability of various pin configurations for pediatric supracondylar humeral fractures under varus, internal rotation, and extension conditions. After electronic retrieval, 11 biomechanical studies were included. Stiffness values of pin configurations under different loading conditions were extracted and pooled. There were no statistically significant differences between two cross pins and two divergent lateral pins on the basis of the 'Hamdi method' (P=0.249-0.737). An additional pin did not strengthen two-pin construct (P=0.124-0.367), but better stabilized fractures with medial comminution (P<0.01). Isolated lateral pins are preferable because of a better balance of a lower risk of nerve injury and comparable fixation strength. Limitations such as differences in experimental setup among recruited studies and small sample size may compromise the methodologic power of this study.
比较不同克氏针构型在小儿肱骨髁上骨折内翻、内旋和伸展条件下的生物力学稳定性。经电子检索，纳入11项生物力学研究。提取并汇总不同加载条件下克氏针构型的刚度值。基于“哈姆迪法”，两根交叉克氏针与两根发散外侧克氏针之间无统计学显著差异（P = 0.249 - 0.737）。额外的一根克氏针并未增强双针固定结构（P = 0.124 - 0.367），但能更好地稳定伴有内侧粉碎的骨折（P < 0.01）。孤立的外侧克氏针更可取，因为其能更好地平衡较低的神经损伤风险和相当的固定强度。本研究存在一些局限性，如纳入研究的实验设置存在差异以及样本量较小，这可能会削弱本研究的方法学效力。
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