Department of Orthopaedic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Department of Orthopaedics and Trauma Surgery, National Trauma Center, National Academy of Medical Sciences, Mahankal, Kathmandu, Nepal.
BMC Musculoskelet Disord. 2020 Nov 11;21(1):735. doi: 10.1186/s12891-020-03774-5.
The clinical outcome of open reduction and internal fixation (ORIF) for delayed lateral condylar fracture of the humerus (LCFH) varies in different studies, but ORIF for LCFH with an early-delayed presentation usually resulted in significant improvement of elbow function. Early delayed presentation is defined as a period of 3 to 12 weeks from the injury. This study aims to compare the clinical outcomes of biodegradable pin (BP) vs. Kirschner wire (KW) in the treatment of LCFH with an early delayed presentation.
LCFH with an early-delayed presentation treated with KW or BP were retrospectively reviewed in our hospital. The patients were divided into two groups KW (n = 17) and BP group (n = 26). Baseline information, including sex, age, operative side, duration from injury to surgery, and implant choice, was reviewed. Radiographs and medical records were collected from the Hospital Database.
In all, 17 patients (male/female, 9/8) in KW and 26 patients (male/female,13/13) in the BP group were included. The age showed no statistically significant difference between the KW (52.3 ± 10.2, month) and the BP (56.1 ± 10.7, month), (P = 0.258). At the last follow-up, there existed no statistically significant difference between the two groups concerning Baumann's angle (P = 0.272) and carrying angle (P = 0.911). The MEPS at the last follow-up was better in the KW group (91.1 ± 2.7) than the BP group (89.2 ± 3.0), (P = 0.048). There was no case of nonunion or malunion in both groups. The incidence of fishtail deformity was (8/17, 47.1%) in KW and (13/26, 50%) in the BP group. The incidence of lateral prominence was (5/17, 29.4%) in the KW and (7/26, 26.9%) in the BP group. Furthermore, the incidence of implant prominence was higher in KW (12/17, 70.6%) than BP (0) (P < 0.001).
Open reduction and internal fixation for LCFH with an early-delayed presentation produced satisfactory outcomes. Biodegradable pin is a good alternative to Kirschner wire, with comparable clinical outcomes.
肱骨外髁延迟骨折（LCFH）切开复位内固定（ORIF）的临床结果在不同的研究中有所不同，但对于早期延迟表现的 LCFH，ORIF 通常会显著改善肘部功能。早期延迟表现定义为受伤后 3 至 12 周。本研究旨在比较生物可吸收钉（BP）与克氏针（KW）治疗早期延迟表现的 LCFH 的临床结果。
回顾性分析我院采用 KW 或 BP 治疗的早期延迟表现的 LCFH。将患者分为 KW 组（n=17）和 BP 组（n=26）。比较两组患者的性别、年龄、手术侧、受伤至手术时间、植入物选择等一般资料。从医院数据库中收集 X 线片和病历。
共纳入 KW 组 17 例（男/女，9/8）和 BP 组 26 例（男/女，13/13）。KW 组和 BP 组的年龄分别为 52.3±10.2（月）和 56.1±10.7（月），差异无统计学意义（P=0.258）。末次随访时，两组间 Baumann 角（P=0.272）和携带角（P=0.911）差异无统计学意义。末次随访时，KW 组 MEPS 为 91.1±2.7，BP 组为 89.2±3.0，差异有统计学意义（P=0.048）。两组均无骨不连或畸形愈合。KW 组出现鱼尾畸形 8 例（8/17，47.1%），BP 组出现鱼尾畸形 13 例（13/26，50%）。KW 组出现外侧突出 5 例（5/17，29.4%），BP 组出现外侧突出 7 例（7/26，26.9%）。此外，KW 组（12/17，70.6%）的植入物突出发生率明显高于 BP 组（0）（P<0.001）。
对于早期延迟表现的 LCFH，切开复位内固定可获得满意的效果。生物可吸收钉是克氏针的良好替代品，具有相似的临床效果。
