Jing Yanhui, Ning Bo, Mo Yueqiang, Wang Dahui
Department of Orthopaedics Surgery, National Children's Medical Center & Children's Hospital of Fudan University, Shanghai, China.
Front Pediatr. 2023 Jan 24;11:1086831. doi: 10.3389/fped.2023.1086831. eCollection 2023.
Supracondylar femoral fractures (SFFs) are uncommon in children but can cause several abnormalities. Although several methods have been employed to treat these fractures, no accepted standard has been established.
To investigate the clinical and radiographic outcomes of displaced SFFs treated with Kirschner wires (K-wires) and hip spica casts in children aged 4-10 years.
We retrospectively reviewed 22 displaced SFFs (mean age, 6.7 years; range, 4-10 years) in patients who underwent surgical treatment with K-wires and hip spica casts. The patients were followed-up frequently, radiographically and clinically between January 2014 and February 2019. Postoperative healing and functional results were elevated according to the radiographic and clinical measures.
Fifteen boys and seven girls were included in this study. All patients except two (91%), underwent closed reduction and stabilization of the fractures. The mean follow-up duration was four years (range, 2-5 years). All fractures showed clinical and radiological evidence of union 4-8 weeks after surgery. At the most recent check-up, all patients reported being pain-free and had returned to normal activities. The mean Knee Society Score was 95.41 at the final follow-up. According to the radiologic criteria, 18 of the 22 patients (81.8%) obtained excellent results, 3 (13.6%) had good results, 1 (4.5%) had a fair result, and none had poor results.
Satisfactory clinical and radiological results can be expected in children aged 4-10 years using a combination of K-wires and hip spica cast fixation.
股骨髁上骨折（SFFs）在儿童中并不常见，但可能会导致多种异常情况。尽管已经采用了多种方法来治疗这些骨折，但尚未确立公认的标准。
探讨克氏针（K 线）和髋人字石膏治疗 4 - 10 岁儿童移位性 SFFs 的临床和影像学结果。
我们回顾性分析了 22 例接受 K 线和髋人字石膏手术治疗的移位性 SFFs 患者（平均年龄 6.7 岁；范围 4 - 10 岁）。在 2014 年 1 月至 2019 年 2 月期间，对患者进行了频繁的影像学和临床随访。根据影像学和临床指标评估术后愈合情况和功能结果。
本研究纳入了 15 名男孩和 7 名女孩。除两名患者（91%）外，所有患者均接受了骨折的闭合复位和固定。平均随访时间为四年（范围 2 - 5 年）。所有骨折在术后 4 - 8 周均显示出临床和影像学愈合证据。在最近一次检查时，所有患者均报告无疼痛，并已恢复正常活动。末次随访时膝关节协会评分平均为 95.41。根据影像学标准，22 例患者中有 18 例（81.8%）获得了优异结果，3 例（13.6%）结果良好，1 例（4.5%）结果尚可，无结果差的病例。
对于 4 - 10 岁的儿童，采用克氏针和髋人字石膏固定相结合的方法，可获得满意的临床和影像学结果。
