Li Jin, Rai Saroj, Tang Xin, Ze Renhao, Liu Ruikang, Hong Pan
Department of Orthopaedic surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Orthopaedics and Trauma Surgery, National Trauma Center, National Academy of Medical Sciences, Kathmandu, Nepal.
Medicine (Baltimore). 2020 Mar;99(10):e19449. doi: 10.1097/MD.0000000000019449.
Radial external fixator has been proposed to treat delayed irreducible Gartland type III supracondylar humeral fracture, and this study aims to compare its effects with crossed pinning in a retrospective fashion. Delayed supracondylar humeral fracture is defined as more than 72 hours after injury, 2 or more than 2 times failed attempts of closed reduction can be deemed as irreducible fracture.Between January 2010 and January 2017, patients of Gartland type III supracondylar fractures of the humerus receiving surgery were all selected and reviewed. Overall, 39 patients fitting the inclusion criteria were chosen for the External Fixator Group and patients for control group of crossed pinning with matched age, sex, and clinical parameters (fracture location, injured side, and fracture type) were selected from the database. Surgery duration, number of intraoperative X-ray images, incidence of ulnar nerve injury, postoperative redisplacement, and function of the elbow joint were recorded and analyzed.In this study, 39 patients treated with radial external fixator had significantly shorter surgery duration, fewer intraoperative X-ray images, and lower incidence of ulnar nerve injury, and postoperative redisplacement than those receiving crossed pinning. Patients in 2 groups displayed similar range of motion for elbow joint at follow-up.Radial external fixator is an effective and safe method to treat Gartland type III supracondylar fractures that were diagnosed late.
已有研究提出采用桡骨外固定架治疗GartlandⅢ型肱骨髁上骨折延迟复位，本研究旨在以回顾性方式比较其与交叉克氏针固定的效果。肱骨髁上骨折延迟复位定义为伤后超过72小时，闭合复位失败2次或2次以上可视为复位失败。选取2010年1月至2017年1月期间接受手术治疗的GartlandⅢ型肱骨髁上骨折患者进行回顾性分析。共纳入39例符合纳入标准的患者作为外固定架组，并从数据库中选取年龄、性别及临床参数（骨折部位、伤侧及骨折类型）相匹配的交叉克氏针固定患者作为对照组。记录并分析手术时间、术中X线透视次数、尺神经损伤发生率、术后再移位情况及肘关节功能。本研究中，采用桡骨外固定架治疗的39例患者手术时间明显短于交叉克氏针固定组，术中X线透视次数更少，尺神经损伤发生率及术后再移位发生率更低。两组患者随访时肘关节活动范围相似。桡骨外固定架是治疗诊断较晚的GartlandⅢ型肱骨髁上骨折的一种有效且安全的方法。
