LiBrizzi Christa L, Klyce Walter, Ibaseta Alvaro, Shannon Claire, Lee R Jay
Division of Pediatric Surgery, Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Medicine (Baltimore). 2020 May;99(20):e20267. doi: 10.1097/MD.0000000000020267.
Supracondylar humerus (SCH) fractures are reported to be approximately twice as common among boys as among girls. Little is known about sex-associated differences in fracture patterns and complications. We compared the incidence of pediatric SCH fractures, injury mechanism (high-energy or low-energy), fracture subtypes, associated neurologic injuries, and treatment types by patient sex.We reviewed 1231 pediatric SCH fractures treated at 1 center from 2008 to 2017, analyzing sex distributions overall and by year and fracture subtype. We noted patient demographic characteristics, injury mechanisms, neurologic injuries, and treatments (nonoperative or operative). Binomial 2-tailed, chi-squared, and Student's t tests were used for analysis. Multiple logistic regression was performed to assess associations between sex, age, and injury mechanism. Alpha = 0.05.We found no significant difference in the distribution of girls (52%) vs boys (48%) in our sample compared with a binomial distribution (P = .11). Annual percentages of fractures occurring in girls ranged from 46% to 63%, and sex distribution did not change significantly over time. The mean (± standard deviation) age at injury was significantly younger for girls (5.5 ± 2.5 years) than for boys (6.1 ± 2.5 years) (P < .001). High-energy injury mechanism was associated with older age (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.03-1.06) but not male sex (OR, 1.04; 95% CI, 0.98-1.1). The overall incidence of neurologic injury was 9.5% but boys did not have greater odds of sustaining neurologic injury (OR, 1.03; 95% CI, 1.0-1.1). We found no sex-associated differences in the distribution of Gartland fracture subtypes (P = .13) or treatment type (P = .39).Compared with boys, girls sustain SCH fractures at a younger age. SCH fractures were distributed equally among girls and boys in our sample. Patient sex was not associated with fracture subtype, injury mechanism, neurologic injury, or operative treatment. These findings challenge the perception that SCH fracture is more common in boys than girls.Level III, retrospective study.
据报道，肱骨髁上骨折（SCH）在男孩中的发生率约为女孩的两倍。关于骨折类型和并发症的性别差异知之甚少。我们比较了儿童SCH骨折的发生率、损伤机制（高能或低能）、骨折亚型、相关神经损伤以及按患者性别划分的治疗类型。
我们回顾了2008年至2017年在1个中心治疗的1231例儿童SCH骨折，分析了总体以及按年份和骨折亚型划分的性别分布。我们记录了患者的人口统计学特征、损伤机制、神经损伤和治疗方法（非手术或手术）。采用二项式双尾检验、卡方检验和学生t检验进行分析。进行多因素逻辑回归以评估性别、年龄和损伤机制之间的关联。α = 0.05。
我们发现，与二项分布相比，我们样本中女孩（52%）和男孩（48%）的分布没有显著差异（P = 0.11）。女孩发生骨折的年度百分比在46%至63%之间，性别分布随时间没有显著变化。女孩受伤时的平均（±标准差）年龄（5.5±2.5岁）显著低于男孩（6.1±2.5岁）（P < 0.001）。高能损伤机制与年龄较大相关（优势比[OR]，1.05；95%置信区间[CI]，1.03 - 1.06），但与男性性别无关（OR，1.04；95% CI，0.98 - 1.1）。神经损伤的总体发生率为9.5%，但男孩遭受神经损伤的几率并不更高（OR，1.03；95% CI，1.0 - 1.1）。我们发现，在Gartland骨折亚型的分布（P = 0.13）或治疗类型（P = 0.39）方面，没有与性别相关的差异。
与男孩相比，女孩发生SCH骨折的年龄更小。在我们的样本中，SCH骨折在女孩和男孩中的分布相等。患者性别与骨折亚型、损伤机制、神经损伤或手术治疗无关。这些发现挑战了肱骨髁上骨折在男孩中比女孩更常见的观念。
三级，回顾性研究。
