Du Xiangping, Yu Lirong, Xiong Zhigang, Chen Gan, Zou Jun, Wu Xinle, Xiong Bin, Wang Baoli
Department of Orthopaedics, Jiangxi Provincial Children's Hospital, Nanchang, China.
Department of Endocrinology, Jiangxi Provincial Children's Hospital, Nanchang, China.
J Int Med Res. 2019 Nov;47(11):5497-5507. doi: 10.1177/0300060519825990. Epub 2019 Aug 19.
To compare the clinical effectiveness of a novel approach, percutaneous leverage reduction using two Kirschner-wires (k-wires) combined with the Métaizeau technique, versus open reduction plus internal fixation with k-wire for the treatment of Judet IV radial neck fractures in children.
Thirty-four patients with Judet IV radial neck fractures were treated either with percutaneous leverage reduction using two k-wires and the Métaizeau technique (n = 16) or open reduction plus internal fixation with k-wire (n = 18). Patient data including sex, age, time from trauma to surgery, fracture type, follow up, postoperative healing time, X-ray studies, elbow function, and complications were collected.
There were no significant differences in patient characteristics between the two treatment groups. In postoperative elbow function assessment, 93.8% of patients in the group that underwent the novel treatment approach had a score of excellent or good, compared with 83.3% of patients in the open reduction and internal fixation with k-wire group. Furthermore, no postoperative complications were reported in patients in the novel treatment group, compared with 5 patients in the open reduction and internal fixation with k-wire group. All patients in both groups were classified as excellent or good according to Métaizeau criteria in postoperative X-ray assessment.
Compared with the open reduction and internal fixation with k-wire approach, percutaneous leverage reduction using two k-wires combined with the Métaizeau technique can significantly increase the minimally invasive reduction rate, and represents an attractive strategy for the treatment of Judet IV radial neck fractures in children.
比较一种新方法，即使用两根克氏针（k 针）结合梅塔佐技术进行经皮撬拨复位，与切开复位加 k 针内固定治疗儿童 Judet IV 型桡骨颈骨折的临床疗效。
34 例 Judet IV 型桡骨颈骨折患者，其中 16 例采用两根 k 针结合梅塔佐技术进行经皮撬拨复位治疗，18 例采用切开复位加 k 针内固定治疗。收集患者的性别、年龄、受伤至手术时间、骨折类型、随访情况、术后愈合时间、X 线检查、肘关节功能及并发症等数据。
两组患者的特征无显著差异。在术后肘关节功能评估中，采用新治疗方法的组中 93.8%的患者评分优良，而切开复位加 k 针内固定组为 83.3%。此外，新治疗组患者未报告术后并发症，而切开复位加 k 针内固定组有 5 例。术后 X 线评估中，两组所有患者根据梅塔佐标准均评定为优良。
与切开复位加 k 针内固定方法相比，使用两根 k 针结合梅塔佐技术进行经皮撬拨复位可显著提高微创复位率，是治疗儿童 Judet IV 型桡骨颈骨折的一种有吸引力的策略。
