Orthopaedics Department of Shenzhen Children's Hospital, No. 7019, Yitian Road, Futian District, Shenzhen, Guangdong, China.
Arch Orthop Trauma Surg. 2022 Nov;142(11):3301-3309. doi: 10.1007/s00402-021-04178-3. Epub 2021 Sep 20.
The aim of this was to analyze the effect of different treatment options on radial neck fractures in children and to explore the factors affecting the prognosis of fractures.
The clinical data of 131 children with radial neck fractures admitted to our hospital from 2010 to 2018 were retrospectively analyzed, and the patients were divided into 6 groups according to treatment methods [manual reduction with Kirschner wires (K-wires) for internal fixation (group A); manual reduction with elastic stable intramedullary nails (ESINs) for internal fixation (group B); leverage reduction with K-wires for internal fixation (group C); leverage reduction with ESINs for internal fixation (group D); manual and leverage reduction with K-wires/ESINs for internal fixation (group E); and open reduction with K-wires/ESINs for internal fixation (group F)]. Postoperative elbow function and complications were analyzed.
Among the 131 patients with fractures, the median age was 8 years, the median preoperative angulation was 52°, the follow-up rate was 86.3% (113/131), the average follow-up time was 58.3 months, and the postoperative complication rate was 17.7% (20/113). The comparison among the different treatment groups showed that group B had the best recovery of elbow function, postoperatively, and the lowest postoperative complication rate. Age, duration of hospitalization, and preoperative angulation were independent factors affecting postoperative complications. Older age, longer duration of hospitalization, and higher angulation increase the postoperative complications.
Different treatment options have different efficacies for radial neck fractures in children, of which manipulative reduction with internal fixation using ESINs can achieve good efficacy and a low postoperative complication rate. Age, duration of hospitalization, and preoperative angulation are independent factors for postoperative complications.
本研究旨在分析不同治疗方案对儿童桡骨颈骨折的影响，并探讨影响骨折预后的因素。
回顾性分析 2010 年至 2018 年我院收治的 131 例儿童桡骨颈骨折患者的临床资料，根据治疗方法将患者分为 6 组[克氏针（K-wire）内固定手动复位组（A 组）；弹性髓内钉（ESIN）内固定手动复位组（B 组）；K-wire 内固定杠杆复位组（C 组）；ESIN 内固定杠杆复位组（D 组）；K-wire/ESIN 内固定手动和杠杆复位组（E 组）；K-wire/ESIN 切开复位内固定组（F 组）]。分析术后肘关节功能及并发症。
131 例骨折患者中，年龄中位数为 8 岁，术前冠状面成角中位数为 52°，随访率为 86.3%（113/131），平均随访时间为 58.3 个月，术后并发症发生率为 17.7%（20/113）。不同治疗组间比较，B 组术后肘关节功能恢复最好，术后并发症发生率最低。年龄、住院时间、术前冠状面成角是影响术后并发症的独立因素。年龄越大、住院时间越长、术前冠状面成角越高，术后并发症发生率越高。
不同治疗方案对儿童桡骨颈骨折的疗效不同，手法复位 ESIN 内固定疗效较好，术后并发症发生率较低。年龄、住院时间、术前冠状面成角是影响术后并发症的独立因素。
