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小儿桡骨颈骨折切开复位及克氏针固定的疗效

Outcome of open reduction and Kirschner wire fixation in pediatric radial neck fracture.

作者信息

Rouhani Alireza, Chavoshi Mohammadreza, Sadeghpour Alireza, Aslani Hossein, Mardani-Kivi Mohsen

机构信息

Department of Orthopedics, Shohada Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.

Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Clin Shoulder Elb. 2021 Dec;24(4):239-244. doi: 10.5397/cise.2021.00402. Epub 2021 Dec 1.

Abstract

BACKGROUND

Radial neck fracture in children is rare. This study attempted to evaluate the outcome of surgically treated patients and any associated complications.

METHODS

This study evaluated 23 children under 15 years of age with radial neck fracture who were treated with open reduction between 2006 and 2016 to determine their range of motion, postoperative complications, and radiographic outcomes. The results were assessed clinically using the Mayo clinic elbow performance score.

RESULTS

The mean follow-up duration for patients was 34.6 months. The average postoperative angulation was 3.6°. Hypoesthesia was reported in only 9% of patients, and none of the patients complained of postoperative pain. The postoperative X-ray results were excellent in 60% and good in 40%. No radiographic complications were identified. The elbow score was excellent in 87% and good in 13% (mean score, 96.74). There was a statistical relationship between range of motion limitations and age, degree of fracture, initial displacement, and surgical pin removal time.

CONCLUSIONS

Although most patients accept the closed reduction method as a primary treatment, the present study suggests that an open-reduction approach has been associated with optimal therapeutic outcomes for patients in whom closed reduction was not satisfactory or indicated.

摘要

背景

儿童桡骨颈骨折较为罕见。本研究旨在评估手术治疗患者的疗效及任何相关并发症。

方法

本研究评估了2006年至2016年间接受切开复位治疗的23例15岁以下桡骨颈骨折患儿,以确定其活动范围、术后并发症及影像学结果。采用梅奥诊所肘关节功能评分对结果进行临床评估。

结果

患者的平均随访时间为34.6个月。术后平均成角为3.6°。仅9%的患者报告有感觉减退,且无患者主诉术后疼痛。术后X线结果60%为优,40%为良。未发现影像学并发症。肘关节评分87%为优,13%为良(平均评分96.74)。活动范围受限与年龄、骨折程度、初始移位及手术钢针取出时间之间存在统计学关系。

结论

尽管大多数患者接受闭合复位方法作为主要治疗手段,但本研究表明,对于闭合复位不满意或不适用的患者,切开复位方法可带来最佳治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/80f2/8651599/cefd5dfb68bd/cise-2021-00402f1.jpg

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