Liu Shuai, Peng YingYing, Liu JiaTong, Ou ZiXuan, Wang ZeZheng, Rai Saroj, Lin WeiFeng, Tang Xin
Pediatric Orthopedics Department, Wuxi 9th People's Hospital Affiliated to Soochow University, Wuxi, China.
Department of Orthopaedic, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Pediatr. 2022 Nov 2;10:1039704. doi: 10.3389/fped.2022.1039704. eCollection 2022.
Supracondylar humeral fractures (SHF) are the most common type of fracture occurring at the distal humerus in children. In patients with delayed presentation of SHF, closed reduction is challenging to achieve with traditional reduction maneuvers. This study aimed to report the clinical results of pediatric SHF delayed over 14 days treated by closed reduction with a minimally invasive technique and external fixation and evaluate the efficacy of this technique.
Between October 2010 and September 2018, children with delayed presentation of SHF over 14 days were retrospectively included in this study. The patients received closed reduction with a minimally invasive technique followed by external fixation. The demographics and radiographic data were collected. The Mayo Elbow Performance Score (MEPS) and the Flynn criteria were used to evaluate the clinical outcomes of treatments.
A total of 11 children (aged 4-13 years) with delayed presentation (range, 14-22 days) were recruited. They received surgery using closed reduction with a minimally invasive technique followed by external fixation. None of the surgery was done with the open method. After surgery, the patients' carrying angle returned to normal. The radiological union was evident in 8 to 12 weeks in all fractures without complications. Every patient had a good to excellent score on the MEPS and the Flynn criteria.
The results of this series indicated a satisfactory outcome in children with delayed more than 14 days of supracondylar humeral fractures. The closed reduction with a minimally invasive technique followed by external fixation is an alternative treatment for such injury.
肱骨髁上骨折（SHF）是儿童肱骨远端最常见的骨折类型。对于就诊延迟的SHF患者，采用传统复位手法难以实现闭合复位。本研究旨在报告采用微创技术闭合复位及外固定治疗延迟超过14天的儿童SHF的临床结果，并评估该技术的疗效。
回顾性纳入2010年10月至2018年9月期间就诊延迟超过14天的SHF患儿。患者接受微创技术闭合复位，随后进行外固定。收集人口统计学和影像学数据。采用梅奥肘关节功能评分（MEPS）和弗林标准评估治疗的临床结果。
共纳入11例就诊延迟（范围为14 - 22天）的儿童（年龄4 - 13岁）。他们接受了微创技术闭合复位及外固定手术，均未采用开放手术方法。术后，患者的提携角恢复正常。所有骨折在8至12周时均可见明显的影像学骨愈合，无并发症发生。根据MEPS和弗林标准，每位患者的评分均为良好至优秀。
本系列结果表明，对于延迟超过14天的肱骨髁上骨折患儿，治疗效果令人满意。微创技术闭合复位及外固定是此类损伤的一种替代治疗方法。
