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儿童肱骨髁上骨折两种固定方法的比较

COMPARISON OF TWO METHODS OF FIXATION OF SUPRACONDYLAR FRACTURES OF THE HUMERUS IN CHILDREN.

作者信息

Natalin Henrique Melo, Silva Jéssica Colamarino Sessa DA, Volpon José Batista

机构信息

Universidade de São Paulo, Ribeirão Preto Medical School Teaching Hospital, Ribeirão Preto, SP, Brazil.

Universidade de São Paulo, Ribeirão Preto Medical School, Ribeirão Preto, SP, Brazil.

出版信息

Acta Ortop Bras. 2021 Sep-Oct;29(5):263-267. doi: 10.1590/1413-785220212905240542.

Abstract

OBJECTIVE

To compare the outcomes of the fixation of complete and displaced supracondylar humeral fractures in children with two different Kirschner wire configurations.

METHODS

The type of fixation was randomized to either crossed (19 cases), or two divergent lateral Kirschner wires (24 cases). The comparison was made six months later between the two treated groups and each group with the non-fractured elbow (clinical alignment, range of motion, Baumann angle, and lateral humeral capitellar angle).

RESULTS

43 children were evaluated (65% boys) with a mean age of six years and five months. The carrying angle (p = 0.94), extension (p = 0.89), and the Flynn´s criteria (p = 0.56) were similar between the groups. The flexion was slightly smaller for the crossed wire group (p = 0.04), but similar to the uninjured side. The Baumann angle was not different between the two fixations (p = 0.79) and the contralateral side (p = 0.1). The lateral humeral capitellar angle was slightly greater for the lateral pinning (p = 0.08), but with no difference with the uninjured elbow (p = 0.62). No iatrogenic injuries were observed.

CONCLUSION

Both fixations presented similar outcomes that did not significantly affect the carrying angle in relation to the non-fractured side.

摘要

目的

比较两种不同克氏针构型治疗儿童完全移位型肱骨髁上骨折的疗效。

方法

将固定方式随机分为交叉克氏针固定(19例)和两根外侧发散克氏针固定(24例)。六个月后对两个治疗组以及每组的未骨折侧肘关节进行比较(临床对线、活动范围、鲍曼角和肱骨小头外侧角)。

结果

共评估43例儿童(65%为男孩),平均年龄6岁5个月。两组之间的提携角(p = 0.94)、伸展度(p = 0.89)和弗林标准(p = 0.56)相似。交叉克氏针组的屈曲度略小(p = 0.04),但与未受伤侧相似。两种固定方式之间的鲍曼角无差异(p = 0.79),与对侧相比也无差异(p = 0.1)。外侧穿针固定的肱骨小头外侧角略大(p = 0.08),但与未受伤的肘关节无差异(p = 0.62)。未观察到医源性损伤。

结论

两种固定方式的疗效相似,与未骨折侧相比,对提携角均无显著影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d1f6/8478429/a7944c50f805/1809-4406-aob-29-05-263-gf1.jpg

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