Menachem S, Sharfman Z T, Perets I, Arami A, Eyal G, Drexler M, Chechik O
Department of Orthopedic Surgery, Haim Sheba Medical Centre, Israel.
Department of Orthopedic Surgery, Tel Aviv Sourasky Medical Centre, Tel Aviv, Israel.
Clin Radiol. 2016 Jun;71(6):616.e1-5. doi: 10.1016/j.crad.2016.02.010. Epub 2016 Mar 23.
To compare the radiographic results of paediatric forearm fracture reduced with and without fluoroscopic enhancement to investigate whether fractures reduced under fluoroscopic guidance would have smaller residual deformities and lower rates of re-reduction and surgery.
A retrospective cohort analysis was conducted comparing paediatric patients with acute forearm fracture in two trauma centres. Demographics and radiographic data from paediatric forearm fractures treated in Trauma Centre A with the aid of a C-arm fluoroscopy were compared to those treated without fluoroscopy in Trauma Centre B. Re-reduction, late displacement, post-reduction deformity, and need for surgical intervention were compared between the two groups.
The cohort included 229 children (175 boys and 54 girls, mean age 9.41±3.2 years, range 1-16 years) with unilateral forearm fractures (83 manipulated with fluoroscopy and 146 without). Thirty-four (15%) children underwent re-reduction procedures in the emergency department. Fifty-three (23%) children had secondary displacement in the cast, of which 18 were operated on, 20 were re-manipulated, and the remaining 15 were kept in the cast with an acceptable deformity. Twenty-nine additional children underwent operation for reasons other than secondary displacement. There were no significant differences in re-reduction and surgery rates or in post-reduction deformities between the two groups.
The use of fluoroscopy during reduction of forearm fractures in the paediatric population apparently does not have a significant effect on patient outcomes. Reductions performed without fluoroscopy were comparably accurate in correcting deformities in both coronal and sagittal planes.
比较在有或没有透视增强辅助下复位的小儿前臂骨折的影像学结果，以研究在透视引导下复位的骨折是否会有更小的残余畸形以及更低的再次复位和手术率。
进行一项回顾性队列分析，比较两个创伤中心的急性小儿前臂骨折患者。将在创伤中心A借助C形臂透视治疗的小儿前臂骨折的人口统计学和影像学数据与在创伤中心B未使用透视治疗的患者数据进行比较。比较两组之间的再次复位、晚期移位、复位后畸形以及手术干预的必要性。
该队列包括229名单侧前臂骨折的儿童（175名男孩和54名女孩，平均年龄9.41±3.2岁，范围1 - 16岁）（83例在透视下进行手法复位，146例未使用透视）。34名（15%）儿童在急诊科接受了再次复位程序。53名（23%）儿童在石膏固定期间出现二次移位，其中18例接受了手术，20例再次进行了手法复位，其余15例在石膏固定下保持可接受的畸形。另有29名儿童因二次移位以外的原因接受了手术。两组之间在再次复位和手术率或复位后畸形方面没有显著差异。
在小儿人群中前臂骨折复位过程中使用透视对患者预后显然没有显著影响。在没有透视的情况下进行的复位在纠正冠状面和矢状面畸形方面同样准确。
