Kasirajan Saravanan, Govindasamy Rajesh, Sathish Bhava Ramalingam Jawaharlal, Meleppuram Jimmy Joseph
Department of Orthopaedics, Vinayaka Missions Medical College and Hospital, Karaikal, India.
BRJ Ortho Centre and Mak Hospital, Coimbatore, India.
Rev Bras Ortop. 2017 Mar 31;53(3):342-349. doi: 10.1016/j.rboe.2017.03.014. eCollection 2018 May-Jun.
The current study aims at a functional analysis of trans-olecranon lateral pinning for displaced supracondylar fracture of the humerus (SCFH) in children.
A prospective study of 48 children (30 males, 18 females; mean age: 7.4 years) with displaced SCFH was treated at this institution with modified technique from March 2011 to September 2014. Cases were selected on the basis of inclusion criteria. The functional outcome was assessed clinically by modified Flynn's criteria along with achievement of full range of motion.
All 48 children with a mean follow up of 20 months (range: 6-26 months) were assessed. All fractures united well. With modified Flynn's criteria, results were excellent in 40 children (83.3%), good in six children (12.5%), and fair in two children (4.2%). There were no poor results. Preoperative nerve palsies seen in four children recovered at ten weeks. Full range of motion was achieved on an average of 20 days after K-wire removal and no new post-operative nerve palsies were noted.
The modified trans-olecranon fossa four-cortex purchase (TOF-FCP) technique was promising in all cases of unstable SCFH without the complications of loss of reduction or iatrogenic ulnar nerve injury. This technique is simple, safe, and reproducible, with good clinical results in this type of fracture.
本研究旨在对儿童肱骨髁上骨折（SCFH）移位采用经鹰嘴外侧穿针固定进行功能分析。
对2011年3月至2014年9月在本机构采用改良技术治疗的48例移位型SCFH儿童（男30例，女18例；平均年龄：7.4岁）进行前瞻性研究。根据纳入标准选择病例。采用改良的弗林标准对功能结果进行临床评估，并评估是否实现了全关节活动范围。
对48例平均随访20个月（范围：6 - 26个月）的儿童进行了评估。所有骨折均愈合良好。根据改良的弗林标准，40例儿童（83.3%）结果为优，6例儿童（12.5%）为良，2例儿童（4.2%）为可。无差的结果。4例术前出现神经麻痹的儿童在10周时恢复。克氏针拔除后平均20天实现了全关节活动范围，且未发现新的术后神经麻痹。
改良的经鹰嘴窝四皮质固定（TOF - FCP）技术在所有不稳定型SCFH病例中均有前景，无复位丢失或医源性尺神经损伤等并发症。该技术简单、安全且可重复，在这类骨折中临床效果良好。
