Körner Daniel, Laux Florian, Stöckle Ulrich, Gonser Christoph
Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tübingen, Eberhard Karls University of Tübingen, Germany.
Orthop Rev (Pavia). 2019 May 23;11(2):7949. doi: 10.4081/or.2019.7949.
The aim of the study was to identify influencing factors on the complication rate in pediatric supracondylar humerus fractures (PSHF). 22 male and 19 female patients with an extension type PSHF underwent conservative and operative treatment at a single trauma department and were reviewed retrospectively. The complications were assessed and the groups of patients with and without complications were compared according to patient- and therapy-related factors. The overall complication rate was 19.5%. Two patients had a primary and 4 patients a postoperative neurological deficit. One patient developed a pin infection after open reduction and crossed pin fixation. One patient underwent early revision surgery because of insufficient initial reduction after closed reduction and crossed pin fixation. All complications appeared in the surgical treatment group. The appearance of complications was significantly associated with a higher Gartland stage. The median time between trauma and operation was significantly longer in patients without compared to patients with complications. PSHF are associated with a high rate of neurological complications. The Gartland stage and the necessity of surgical treatment are the major influencing factors on the complication rate.
本研究的目的是确定小儿肱骨髁上骨折(PSHF)并发症发生率的影响因素。22例男性和19例女性伸展型PSHF患者在单一创伤科室接受了保守和手术治疗,并进行了回顾性分析。评估并发症情况,并根据患者和治疗相关因素对有并发症和无并发症的患者组进行比较。总体并发症发生率为19.5%。2例患者出现原发性神经功能缺损,4例患者术后出现神经功能缺损。1例患者在切开复位和交叉克氏针固定后发生针道感染。1例患者因闭合复位和交叉克氏针固定后初始复位不充分而接受了早期翻修手术。所有并发症均出现在手术治疗组。并发症的出现与较高的Gartland分期显著相关。与有并发症的患者相比,无并发症患者创伤至手术的中位时间明显更长。PSHF与较高的神经并发症发生率相关。Gartland分期和手术治疗的必要性是并发症发生率的主要影响因素。