Massetti Daniele, Marinelli Mario, Facco Giulia, Falcioni Danya, Giampaolini Nicola, Specchia Nicola, Gigante Antonio Pompilio
Clinical Orthopaedics, Department of Clinical and Molecular Sciences, School of Medicine, Università Politecnica delle Marche, Via Conca, Torrette, 60100, Ancona, Italy.
Clinic of Adult and Paediatric Orthopaedics, Azienda Ospedaliero-Universitaria, Ospedali Riuniti di Ancona, Ancona, Italy.
Eur J Orthop Surg Traumatol. 2020 Jul;30(5):931-937. doi: 10.1007/s00590-020-02654-x. Epub 2020 Mar 14.
To describe clinical and radiographic outcomes after surgical management of angulated radial neck fracture in children.
Twenty children (aged 2-11 years) with angulated radial neck fracture with more than 30° angulations (Judet type III and IV fractures) were retrospectively reviewed. All the enrolled patients were surgically treated with percutaneous k-wire leverage reduction and retrograde transphyseal k-wire fixation. Clinical outcomes were evaluated using Tibone and Stoltz score and the Mayo Elbow Performance Score (MEPS). Radiographic outcomes were evaluated with Métaizeau score. Complications were also evaluated.
At a mean follow-up of 20 months, no patients showed axial deformity of the upper limb or instability of the elbow. The mean value of the MEPS was 99.2, and excellent clinical results were achieved in 14 patients (73.7%) at Tibone and Stoltz score. The final X-rays showed fracture healing in all patients; furthermore, 75% of patients showed excellent reduction at Métaizeau score. No patient developed complication. There were no iatrogenic nerve injuries or pin infections.
The results demonstrate that percutaneous k-wire leverage reduction and retrograde transphyseal k-wire fixation of angulated radial neck fracture treatment is a simple, effective, rapid and inexpensive procedure.
IV (case series and systematic review of level IV studies).
描述儿童桡骨颈成角骨折手术治疗后的临床和影像学结果。
回顾性分析20例年龄在2至11岁之间、成角大于30°的桡骨颈成角骨折患儿（Judet III型和IV型骨折）。所有纳入患者均接受经皮克氏针撬拨复位及逆行经骨骺克氏针内固定手术治疗。临床结果采用Tibone和Stoltz评分以及梅奥肘关节功能评分（MEPS）进行评估。影像学结果采用梅塔佐评分进行评估。同时对并发症进行评估。
平均随访20个月，无患者出现上肢轴向畸形或肘关节不稳定。MEPS的平均值为99.2，14例患者（73.7%）在Tibone和Stoltz评分中获得了优异的临床结果。最终X线显示所有患者骨折均愈合；此外，75%的患者在梅塔佐评分中显示复位良好。无患者发生并发症。未出现医源性神经损伤或钢针感染。
结果表明，经皮克氏针撬拨复位及逆行经骨骺克氏针内固定治疗桡骨颈成角骨折是一种简单、有效、快速且经济的手术方法。
IV级（IV级研究的病例系列和系统评价）。
