Department of Orthopaedic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
J Shoulder Elbow Surg. 2020 Apr;29(4):845-852. doi: 10.1016/j.jse.2019.12.026.
Cubitus varus deformity is a well-known late complication of supracondylar fractures in children. In this retrospective study, the primary objective was to compare clinical and radiologic outcomes of lateral closing-wedge osteotomy with either internal fixation or external fixation in pediatric patients with cubitus varus deformities.
From 2010 to 2017, 35 consecutive patients with cubitus varus deformities secondary to supracondylar fractures were included in this study. After corrective osteotomy was performed via a limited lateral approach, the method of definitive fixation was chosen between internal and external. Retrospectively, patients who underwent external fixation on the lateral aspect of the elbow were defined as group I (n = 16) whereas patients with unilateral single-plate fixation were defined as group II (n = 19). The functional outcome was evaluated using the Mayo Elbow Performance Score and Flynn criteria.
No significant difference in age was found between the 2 groups (P = .15). Significantly lower costs, a shorter operation duration, smaller scars, and a shorter time for plaster cast use postoperatively were found in group I (P < .001). No nonunion or failure of fixation was found. No significant difference was noted in postoperative elbow range of motion or Mayo Elbow Performance Score (P = .64). Both groups achieved satisfactory functional and cosmetic results.
In pediatric patients with cubitus varus, both methods of fixation after lateral closing-wedge corrective osteotomy are reliable, with a low rate of complications and satisfactory functional results. External fixation is more advantageous in terms of easier preoperative planning, shorter operative times, lower costs, and easier postoperative fixation removal.
肘内翻畸形是儿童肱骨髁上骨折的一种常见晚期并发症。在这项回顾性研究中，主要目的是比较外侧闭合楔形截骨术联合内固定或外固定治疗儿童肘内翻畸形的临床和影像学结果。
2010 年至 2017 年，我们共纳入 35 例继发于肱骨髁上骨折的肘内翻畸形患者。在通过有限的外侧入路进行矫正截骨术后，选择内固定或外固定作为最终固定方式。回顾性地，将在肘外侧行外固定的患者定义为 I 组（n = 16），将行单侧单钢板固定的患者定义为 II 组（n = 19）。采用 Mayo 肘关节功能评分和 Flynn 标准评估功能结果。
两组患者的年龄差异无统计学意义（P =.15）。I 组的费用更低、手术时间更短、切口更小、术后石膏固定时间更短（P <.001）。两组均未发生骨不连或固定失败。术后肘关节活动范围和 Mayo 肘关节功能评分差异无统计学意义（P =.64）。两组均获得了满意的功能和美容效果。
对于儿童肘内翻患者，外侧闭合楔形截骨矫正术后两种固定方法均可靠，并发症发生率低，功能结果满意。与内固定相比，外固定在术前计划制定、手术时间、费用和术后固定去除方面更具优势。
