Alagöz Ender, Güleç Mehmet Akif
Department of Orthopedics and Traumatology, University of Health Sciences Bağcılar Training and Research Hospital, Istanbul, Turkey.
Jt Dis Relat Surg. 2020;31(1):95-101. doi: 10.5606/ehc.2020.71523.
This study aims to investigate the factors affecting the loss of reduction in pediatric diaphyseal forearm fractures and to compare the three-point index (TPI) with the cast index, padding index, Canterbury index, and gap index.
This retrospective study, which was conducted between January 2016 and December 2016, included 159 patients (134 males, 25 females; mean age 8.1±2.8 years; range, 3 to 13 years) with diaphyseal forearm fracture. Patients' age, gender, and the level, displacement, and location of the fractures were recorded. The presence of anatomic reduction, a straight ulnar border, and the cast type (banana or box type) were checked after the reduction. The TPI, cast index, padding index, Canterbury index, and gap index were measured.
Fifty-two patients (32.7%) experienced loss of reduction during the follow-up. Displaced fractures of both the radius and the ulna, cast type-banana, anatomical reduction, straight ulnar border, TPI, cast index, padding index, and Canterbury index were found to be associated with re-displacement.
Although cast indices can be used as a beneficial clinical tool in predicting the loss of reduction in the treatment of pediatric forearm fractures, they may not be sufficient when used alone. Obtaining a more accurate result may be possible by assessing several parameters such as the presence of an anatomic reduction, box-type casting, and TPI together.
本研究旨在探讨影响小儿尺桡骨干骨折复位丢失的因素，并比较三点指数（TPI）与石膏指数、衬垫指数、坎特伯雷指数和间隙指数。
本回顾性研究于2016年1月至2016年12月进行，纳入159例尺桡骨干骨折患者（男134例，女25例；平均年龄8.1±2.8岁；范围3至13岁）。记录患者的年龄、性别以及骨折的部位、移位情况和位置。复位后检查解剖复位情况、尺骨边缘是否笔直以及石膏类型（香蕉型或盒型）。测量TPI、石膏指数、衬垫指数、坎特伯雷指数和间隙指数。
52例患者（32.7%）在随访期间出现复位丢失。桡骨和尺骨的移位骨折、石膏类型-香蕉型、解剖复位、尺骨边缘笔直、TPI、石膏指数、衬垫指数和坎特伯雷指数均与再次移位有关。
虽然石膏指数可作为预测小儿前臂骨折治疗中复位丢失的有益临床工具，但单独使用时可能并不充分。通过综合评估几个参数，如解剖复位情况、盒型石膏固定和TPI，可能会获得更准确的结果。
