克氏针固定能否改善西摩氏骨折患儿的治疗效果？
Does K-wire fixation improve outcomes in children with a Seymour fracture?
作者信息
Houlden Riki
机构信息
East & North Hertfordshire NHS Trust, Stevenage, UK.
出版信息
Ann Med Surg (Lond). 2022 Sep 9;82:104566. doi: 10.1016/j.amsu.2022.104566. eCollection 2022 Oct.
INTRODUCTION
The Seymour fracture is a juxta-epiphyseal fracture of the terminal phalanx of the finger. Sources vary on the recommended management, with some advocating treatment without K-wires to avoid metalwork-associated infection, and others suggesting that K-wire fixation is necessary due to the risks of fracture re-displacement.
METHODS
A best evidence topic in paediatric hand surgery was written according to a structured protocol. Searches were performed on December 28, 2021 in Cochrane library and PubMed.
RESULTS
69 papers were found using the reported search strategy, and eight papers representing the best evidence to answer this question are discussed.
DISCUSSION
The evidence on this subject is suboptimal as five of these studies were case-series that do not make direct comparisons between the question's intervention and control groups, and the other three were single-centre retrospective cohort studies with no randomisation.
CONCLUSION
The best evidence topic concludes that K-wire fixation appears to be associated with a higher rate of physeal disturbance and lower rates of infection, fracture re-displacement, and flexion deformity.
引言
西摩骨折是手指末节指骨的近骨骺骨折。关于推荐的治疗方法，不同来源的观点有所不同，一些人主张不使用克氏针治疗以避免与金属器械相关的感染，而另一些人则认为由于骨折再移位的风险，克氏针固定是必要的。
方法
根据结构化方案撰写了一篇小儿手外科的最佳证据主题。于2021年12月28日在Cochrane图书馆和PubMed上进行了检索。
结果
使用报告的检索策略共找到69篇论文，并讨论了代表回答该问题的最佳证据的8篇论文。
讨论
关于这个主题的证据并不理想，因为这些研究中有五项是病例系列研究，没有在问题的干预组和对照组之间进行直接比较，另外三项是单中心回顾性队列研究，没有随机分组。
结论
最佳证据主题得出结论，克氏针固定似乎与更高的骨骺干扰率以及更低的感染率、骨折再移位率和屈曲畸形率相关。
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