Banshelkikar Santosh, Sheth Binoti, Banerjee Subhashis, Maaz Mohammad
Department of Orthopaedics, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, India.
J Clin Orthop Trauma. 2020 Aug 21;13:78-81. doi: 10.1016/j.jcot.2020.08.012. eCollection 2021 Feb.
A variety of fracture patterns are seen in supracondylar humerus fractures in children and these are well described by Bahk et al. Currently followed treatment protocol doesn't recognize these common fracture patterns and pin placement is done at the discretion of the treating surgeon. The aim of the study is to evaluate the usefulness of Bahk classification system in deciding the pin configuration for the specific fracture patterns and thereby assess the functional outcome in the management of supracondylar fractures in children.
The study was done on 100 children of 2-12 years of age from February 2019 to January 2020. After closed reduction under general anesthesia, fractures were classified and pin configuration was decided according to Bahk classification. In the follow-up, patients were assessed for clinicoradiological outcomes based on Modified Flynn's criteria, Baumann angle, and anterior humeral line.
In our study Typical transverse and low sagittal fracture were the most common fracture patterns. In the final follow up as per Flynn's criteria, 93% of the patients showed excellent results. Mean Baumann's angle was not significantly different from the uninjured side and anterior humeral line passed through anterior or middle third of the capitulum in 95% patients.
Using pin configuration suitable to fracture pattern as per Bahk classification improves functional outcome in supracondylar humerus fractures in children and minimizes complications.
儿童肱骨髁上骨折可见多种骨折类型,Bahk等人对此有详细描述。目前遵循的治疗方案未考虑这些常见骨折类型,克氏针的置入由主刀医生自行决定。本研究的目的是评估Bahk分类系统在为特定骨折类型确定克氏针配置方面的实用性,从而评估儿童肱骨髁上骨折治疗的功能结果。
本研究对2019年2月至2020年1月期间100名2至12岁的儿童进行。在全身麻醉下进行闭合复位后,根据Bahk分类对骨折进行分类并确定克氏针配置。在随访中,根据改良Flynn标准、鲍曼角和肱骨前线对患者的临床和放射学结果进行评估。
在我们的研究中,典型横行和低位矢状骨折是最常见的骨折类型。在最终随访中,根据Flynn标准,93%的患者显示出优异的结果。平均鲍曼角与未受伤侧无显著差异,95%的患者肱骨前线穿过肱骨小头的前三分之一或中三分之一。
根据Bahk分类使用适合骨折类型的克氏针配置可改善儿童肱骨髁上骨折的功能结果并减少并发症。