Vergara Alberto Daniel Navarro, Fretes Alberto Navarro
Departamento de Pediatria, Unidade de Ortopedia e Traumatologia Infantil, Hospital de Trauma Manuel Giagni, Assunção, Paraguai.
Departamento de Ortopedia Infantil, Hospital Central del Instituto de Previsión Social (HC-IPS), Assunção, Paraguai.
Rev Bras Ortop (Sao Paulo). 2022 Oct 14;58(1):149-156. doi: 10.1055/s-0042-1757307. eCollection 2023 Feb.
To compare the use of cannulated screws and smooth Kirschner wires in terms of reducing the presence of exuberant callus and complications in pediatric displaced fractures of the lateral humeral condyle. An analytical cross-sectional study of consecutive cases was conducted from May to October 2021 with 30 children with displaced external humeral condyle fractures. The functional results regarding pain and range of motion were stratified using the Dhillon grading system. A total of 19 patients underwent Kirschner wire fixation, and 11 underwent cannulated screw fixation. Closed fixation was performed in 14 cases (47%), and open fixation, in 16 (53%). Of the cases included, there was no loss to follow-up. Te sample was composed of 21 (70%) male patients, and the age ranged from 5 to 15 years, with a mean of 6.96 years. The most frequent cause of fracture was fall from height (50%), which was related to greater displacement on baseline radiographs. Complications that were not related to the reduction approach or the implant used were observed in 12 (40%) cases. The present study shows no benefits in relation to the use of smooth pins or cannulated screws to reduce the presence of exuberant callus in the consolidation of the fracture. We see that the complications that arise are related to the severity of the injury, and benefits cannot be identified in the choice of one implant over another. We could see that the Weiss classification helps to define the behavior in favor of open or closed reduction without interfering in kindness of the smooth pin or the cannulated screw for fracture fixation.
比较空心螺钉和光滑克氏针在减少小儿肱骨外侧髁移位骨折中骨痂过度生长及并发症方面的应用。
2021年5月至10月对连续病例进行了一项分析性横断面研究,纳入30例肱骨外侧髁移位骨折患儿。使用Dhillon分级系统对疼痛和活动范围的功能结果进行分层。
共19例患者接受克氏针固定,11例接受空心螺钉固定。14例(47%)进行闭合固定,16例(53%)进行切开固定。纳入的病例均无失访。样本由21例(70%)男性患者组成,年龄5至15岁,平均6.96岁。最常见的骨折原因是高处坠落(50%),这与基线X线片上更大的移位有关。12例(40%)观察到与复位方法或所用植入物无关的并发症。
本研究表明,在骨折愈合过程中,使用光滑钢针或空心螺钉减少骨痂过度生长并无益处。我们发现出现的并发症与损伤的严重程度有关,在选择一种植入物而非另一种植入物时无法确定其益处。我们可以看到,Weiss分类有助于确定有利于切开或闭合复位的行为,而不会干扰用于骨折固定的光滑钢针或空心螺钉的类型。