Heare Austin, Goral Dawn, Belton Matthew, Beebe Corey, Trizno Anastasiya, Stoneback Jason
*Department of Orthopedic Surgery, University of Colorado School of Medicine, Aurora, CO; and †Musculoskeletal Research Center, Children's Hospital Colorado, Aurora, CO.
J Orthop Trauma. 2017 Oct;31(10):e334-e338. doi: 10.1097/BOT.0000000000000925.
To compare outcomes and costs between titanium elastic nails (TENs), stainless steel elastic nails (SENs), and Kirschner wires (K-wires) in the treatment of pediatric diaphyseal forearm fractures with intramedullary fixation.
Retrospective cohort study.
Level 1 Pediatric Trauma Center.
PATIENTS/PARTICIPANTS: A total of 100 patients (65 male and 35 female) younger than 18 years with diaphyseal forearm fractures treated with intramedullary fixation were included in the study.
Patients received single or both bone intramedullary fixation with either TENs, SENs, or K-wires.
Time to radiographic union, complication rate, surgical time, and average cost per implant.
One hundred patients were included in the study. Thirty-one patients were treated with TENs, 30 with SENs, and 39 with K-wires. No significant difference in time to radiographic union, complication rate, or surgical time was found between the 3 types of fixation. Average time to union was 9.4 ± 5.4 weeks, and complication rate was 12.9% for TENs, 10.0% for SENs, and 12.8% for K-wires. There was a significant difference in cost per implant, with an average cost of $639, $172, and $24 for TENs, SENs, and K-wires, respectively (P < 0.001).
This study demonstrates no difference between TENs, SENs, and K-wires in the treatment of pediatric diaphyseal forearm fractures with regards to outcome, time to union, surgical time, or complication rates. Given the significant cost difference between these implants, we recommend that surgeons consider modifying their implant selection to help mitigate cost.
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
比较钛弹性髓内钉（TENs）、不锈钢弹性髓内钉（SENs）和克氏针（K 针）治疗小儿尺桡骨干骨折髓内固定的疗效及费用。
回顾性队列研究。
一级儿童创伤中心。
患者/参与者：本研究纳入了 100 例 18 岁以下采用髓内固定治疗尺桡骨干骨折的患者（65 例男性，35 例女性）。
患者接受单骨或双骨髓内固定，使用 TENs、SENs 或 K 针。
影像学愈合时间、并发症发生率、手术时间及每种植入物的平均费用。
本研究共纳入 100 例患者。31 例患者使用 TENs 治疗，30 例使用 SENs 治疗，39 例使用 K 针治疗。三种固定方式在影像学愈合时间、并发症发生率或手术时间方面未发现显著差异。平均愈合时间为 9.4±5.4 周，TENs 的并发症发生率为 12.9%，SENs 为 10.0%，K 针为 12.8%。每种植入物的费用存在显著差异，TENs、SENs 和 K 针的平均费用分别为 639 美元、172 美元和 24 美元（P<0.001）。
本研究表明，在治疗小儿尺桡骨干骨折方面，TENs、SENs 和 K 针在疗效、愈合时间、手术时间或并发症发生率方面无差异。鉴于这些植入物之间存在显著的费用差异，我们建议外科医生考虑调整植入物的选择以降低费用。
治疗性三级证据。有关证据级别的完整描述，请参阅作者指南。
