Department of Orthopedics and Trauma Surgery, Karnali Academy of Health Sciences, Jumla, Nepal.
Nepal Orthopaedic Hospital, Kathmandu, Nepal.
J Nepal Health Res Counc. 2020 Apr 20;18(1):41-46. doi: 10.33314/jnhrc.v18i1.2326.
The purpose of this study is to compare the clinical and radiological outcome of medial versus posterior triceps splitting approach in open reduction internal fixation of displaced supracondylar fracture of humerus in children.
A retrospective review of total 70 children with medial approach (n=30) and posterior triceps splitting approach (n=40) children was made. Time to radiological union, postoperative Bauman's angle and Lateral humerocapitellar angle was compared for radiological outcome. Cosmetic and functional outcome was assessed and compared using Flynn's criteria.
Radiological parameters like time to union, postoperative Bauman's angle and Lateral humerocapitellar angle were similar and non-significant between medial and posterior triceps splitting approach. Flynn's cosmetic outcome was similar between these approach (p=0.198). Loss of ROM was significant in posterior triceps splitting approach (p=0.00). Flynn's functional outcome was better with medial approach as compared to posterior triceps splitting approach with statistical significance (p=0.00).
Medial approach has better functional outcome compared to posterior triceps splitting approach in open reduction internal fixation of displaced supracondylar fracture of humerus in children.
本研究旨在比较儿童移位性肱骨髁上骨折切开复位内固定中肱三头肌内侧入路与后侧劈开入路的临床和影像学结果。
回顾性分析了 70 例采用肱三头肌内侧入路（n=30）和后侧劈开入路（n=40）的儿童患者。比较了影像学结果的影像学愈合时间、术后 Bauman 角和外侧肱尺角。采用 Flynn 标准评估和比较美容和功能结果。
愈合时间、术后 Bauman 角和外侧肱尺角等影像学参数在肱三头肌内侧入路和后侧劈开入路之间相似且无统计学意义。这两种方法的美容结果相似（p=0.198）。后侧劈开入路的 ROM 丢失明显（p=0.00）。与后侧劈开入路相比，内侧入路的功能结果更好，具有统计学意义（p=0.00）。
与后侧劈开入路相比，儿童移位性肱骨髁上骨折切开复位内固定中肱三头肌内侧入路具有更好的功能结果。
