Department of Pediatric Surgery, University Hospital of Split, Split, Croatia;Department of Surgery, University of Split, School of Medicine, Split, Croatia;Clinic of Pediatric Surgery, General Hospital Zadar, Zadar, Croatia.
Department of Surgery, University of Split, School of Medicine, Split, Croatia.
Acta Orthop Traumatol Turc. 2020 Nov;54(6):618-622. doi: 10.5152/j.aott.2020.19223.
The aim of this study was to analyze the outcomes of treatment and the rate of complications in children treated with flexible intramedullary nailing (FIN) for radial neck fractures.
The study included 26 children (11 males and 15 females) with a median age of 9.5 years, treated with FIN for the radial neck fractures between May 2011 and May 2018. Immobilization after the surgery was not used. The median follow-up was 41 months. According to the Judet classification, 15 fractures were classified as type III and 11 as Type IV. For each patient, clinical, radiological, and disability of the arm, shoulder, and hand (DASH) scores were calculated.
All patients achieved complete radiographic healing at a median of 5 weeks. The nails were removed at a median of 4 months. The rate of complications was 11.5%, including 1 radial head necrosis, 1 angulation of 15°, and 1 displacement of the radial head. Twenty patients (76.9%) achieved a perfect clinical healing, while 23 patients (88.5%) achieved a perfect radiological healing. The median DASH score was 1.25. No cases of delayed healing were recorded. After removing of the nails, all patients returned to full function of the extremity and all complications were resolved.
The use of FIN for treating fractures of the radial neck in children shows very good functional and cosmetic results. It allows mobilization with rapid pain reduction. It is a minimally invasive, simple, and reproducible technique with a low rate of complication. Owing to excellent results, surgical stabilization of radial head and neck fractures using FIN is recommended in children and adolescents.
Level IV, Therapeutic study.
本研究旨在分析儿童桡骨颈骨折采用弹性髓内钉（FIN）治疗的疗效和并发症发生率。
本研究纳入了 2011 年 5 月至 2018 年 5 月期间采用 FIN 治疗的 26 例儿童（男 11 例，女 15 例）桡骨颈骨折患者，术后不进行固定。中位随访时间为 41 个月。根据 Judet 分类，15 例骨折为 Ⅲ 型，11 例为 Ⅳ 型。对每位患者计算临床、影像学和上肢功能障碍评分（DASH）。
所有患者均在 5 周的中位数时间内实现完全影像学愈合，中位时间 4 个月时取出内固定。并发症发生率为 11.5%，包括 1 例桡骨头坏死、1 例 15°成角和 1 例桡骨头移位。20 例（76.9%）患者临床愈合完美，23 例（88.5%）患者影像学愈合完美。DASH 评分中位数为 1.25，无愈合延迟病例。取出内固定后，所有患者的肢体功能均完全恢复，所有并发症均得到解决。
儿童桡骨颈骨折采用 FIN 治疗具有非常好的功能和美容效果，可早期活动，快速减轻疼痛。该技术微创、简单、可重复，并发症发生率低。鉴于其良好的效果，建议在儿童和青少年中采用 FIN 对桡骨头和颈骨折进行手术固定。
IV 级，治疗性研究。
