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可生物降解钢针是儿童肱骨外侧髁骨折的良好选择吗:可生物降解钢针与克氏针的比较研究

Is biodegradable pin a good choice for lateral condylar fracture of humerus in children: A comparative study of biodegradable pin and Kirschner wire.

作者信息

Li Jin, Rai Saroj, Liu Yudong, Ze Renhao, Tang Xin, Liu Ruikang, Hong Pan

机构信息

Department of Orthopaedic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Department of Orthopaedics and Trauma Surgery, National Trauma Center, National Academy of Medical Sciences, Mahankal, Kathmandu, Nepal.

出版信息

Medicine (Baltimore). 2020 Aug 14;99(33):e21696. doi: 10.1097/MD.0000000000021696.

Abstract

INTRODUCTION

Lateral condylar fracture (LCF) of the humerus in children is one of the commonest elbow injuries in children. Early recognition of the problem and appropriate management usually yields satisfactory outcomes. Closed or open reduction with Kirschner-wire (KW) is a cost-effective choice of fixation method for displaced fracture. However, various other methods, including partially threaded cannulated cancellous screw and biodegradable pin (BP), have also been used. This study aimed to investigate the efficacy of BP and compare its clinical outcomes with KW.

MATERIAL AND METHODS

Patients with LCF admitted from January 2008 to January 2016 at our institute were reviewed retrospectively. Baseline information and clinical data were collected from Hospital Database. Patients were divided into the KW group and BP group.

RESULTS

In all, 85 patients (male 50, female 35) in the KW group and 76 patients (male 47, female 29) in the BP group were included in this study. The average age of patients in the KW group was 5.2 years, and that of BP was 5.9 years. No nonunion or malunion was observed in either group. At the last follow-up visit, there was no statistically significant difference between the 2 groups with regard to elbow function and appearance. The incidence of long-term complications, including avascular necrosis, fishtail deformity, and lateral prominence, showed no significant difference between both the groups. The incidence of hardware prominence was higher in the KW (13/85, 15.6%) than BP (2/76, 2.6%) group (P < .001).

CONCLUSIONS

Both KW and BP are safe and effective choices for LCF of the humerus in children. Both the implant designs produce satisfactory and comparable clinical outcomes. However, BP has the advantage of less hardware prominence, no need for hardware removal, and fewer long-term complications.

摘要

引言

儿童肱骨外侧髁骨折(LCF)是儿童最常见的肘部损伤之一。早期识别问题并进行适当处理通常能取得满意的结果。对于移位骨折,闭合或切开复位克氏针(KW)固定是一种经济有效的固定方法选择。然而,也使用了其他各种方法,包括部分螺纹空心松质骨螺钉和生物可降解针(BP)。本研究旨在探讨BP的疗效,并将其临床结果与KW进行比较。

材料与方法

回顾性分析2008年1月至2016年1月在我院收治的LCF患者。从医院数据库收集基线信息和临床数据。将患者分为KW组和BP组。

结果

本研究共纳入KW组85例患者(男50例,女35例)和BP组76例患者(男47例,女29例)。KW组患者的平均年龄为5.2岁,BP组为5.9岁。两组均未观察到骨不连或畸形愈合。在最后一次随访时,两组在肘关节功能和外观方面无统计学显著差异。包括缺血性坏死、鱼尾畸形和外侧突出在内的长期并发症发生率在两组之间无显著差异。KW组(13/85,15.6%)的内固定突出发生率高于BP组(2/76,2.6%)(P<0.001)。

结论

KW和BP都是儿童肱骨LCF安全有效的选择。两种植入物设计均产生令人满意且相当的临床结果。然而,BP具有内固定突出较少、无需取出内固定以及长期并发症较少的优点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d26/7437816/249277ac8fed/medi-99-e21696-g001.jpg

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