Sahin E, Zehir S, Sipahioglu S
Department of Orthopedics and Traumatology, Faculty of Medicine, Bülent Ecevit University, Zonguldak, Turkey.
Department of Orthopedics and Traumatology, Faculty of Medicine, Hitit University, Çorum, Turkey.
Niger J Clin Pract. 2017 Sep;20(9):1106-1111. doi: 10.4103/njcp.njcp_104_16.
The aim of the current study was to compare the clinical results of pediatric supracondylar humerus fracture cases requiring open reduction through medial approach with posterior approach.
Retrospective cohort of 67 cases of pediatric supracondylar fractures was reviewed. Thirty-three patients (20 males, 13 female, average age: 8.3 ± 3.131) were treated with medial approach were compared with 34 patients (19 males, 15 females, average age: 7.5 ± 3.146) treated with posterior exposure. Median follow-up period of the first group was 35.04 months (range: 17-76 months) and of the second group was 36.04 (range: 16-65 months). Radiological evaluation included Baumann angle, carrying angles, and lateral humero-capitellar angles. Functional and cosmetic evaluation was assessed with range-of-motion measurements and the criteria defined by Flynn et al.
No differences between groups were noted regarding gender, age, and follow-up periods. Operative time was significantly shorter in medial approach group [60.0 ± 14.5 vs. 75.8 ± 17.6 min (P = 0.002)]. Radiological measurements (Baumann, humero-capitellar, and carrying angles) were also similar between groups. When evaluated patients according to Flynn's criteria, for medial group, 31 cases (93.9%) had good-perfect result regarding ROM loss, whereas for posterior group 33 cases (97%) had good-perfect result. Regarding carrying angle change and posterior group were slightly better than medial group (perfect result observed in 91.1% vs 81.8%, respectively). The differences did not show statistical significance.
In the treatment of supracondylar humerus fractures in children, both surgical approaches revealed similar functional and radiological outcomes with shorter operative time when medial approach was utilized.
本研究旨在比较采用内侧入路与后入路切开复位治疗小儿肱骨髁上骨折的临床效果。
回顾性分析67例小儿髁上骨折病例。将采用内侧入路治疗的33例患者（20例男性，13例女性，平均年龄：8.3±3.131岁）与采用后入路治疗的34例患者（19例男性，15例女性，平均年龄：7.5±3.146岁）进行比较。第一组的中位随访期为35.04个月（范围：17 - 76个月），第二组为36.04个月（范围：16 - 65个月）。影像学评估包括鲍曼角、提携角和肱骨小头外侧角。功能和外观评估采用活动度测量以及弗林等人定义的标准进行。
两组在性别﹑年龄和随访时间方面无差异。内侧入路组的手术时间明显更短[60.0±14.5 vs. 75.·8±17.6分钟（P = 0.002）]。两组间的影像学测量值（鲍曼角、肱骨小头角和提携角）也相似。根据弗林标准评估患者时，内侧入路组在活动度丧失方面，31例（93.9%）结果为优 - 良，而后入路组33例（97%）结果为优 - 良。在提携角变化方面，后入路组略优于内侧入路组（分别为91.1%和81.8%观察到优的结果）。差异无统计学意义。
在小儿肱骨髁上骨折的治疗中，两种手术入路在功能和影像学结果方面相似，且采用内侧入路时手术时间更短。
