Chen Kai, Gu Kai, Su Yuxi
Department of Orthopedics, Children's Hospital of Chongqing Medical University; Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Jiangxi Hospital Affiliated Children's Hospital of Chongqing Medical University, Chongqing, P.R. China.
Acta Orthop Traumatol Turc. 2023 Mar;57(2):55-60. doi: 10.5152/j.aott.2023.21145.
The aim of this study was to evaluate the outcomes of pediatric patients who were treated for olecranon and displaced radial neck fractures with absorbable rods and Kirschner wires.
Thirty-one patients (20 male, 11 female), aged from 3 to 13 years old with olecranon and displaced radial neck fractures treated with absorbable rods and Kirschner wires, were included in this retrospective, single-center study. All radial neck fractures were Judet type IV, and there were 17 type C and 14 type D olecranon fractures. The follow-up time ranged from 26 to 56 months (average 35.8 months). The Boyd approach was used first to reduce olecranon fractures and fix them with Kirschner wires. Thereafter, radial neck fractures were reduced and fixed with absorbable rods. Patients' functional outcomes were assessed using the Mayo Elbow Performance Index score.
Results were excellent in 19 patients, good in 8 patients, fair in 2 patients, and poor in 2 cases according to the Mayo Elbow Performance Index score. The rate of excellent and good outcomes was 87.1%. The average Mayo Elbow Performance Index score was 91.5 points. Three patients showed radial nerve injuries preoperatively, which were assessed intraoperatively. No nerve repair was required, and all nerve injuries recovered within 3 months.
This study has shown us that using a Boyd approach for open reduction and fixation with absorbable rods and K-wires is feasible for olecranon and severely displaced radial neck fractures in pediatric patients.
Level IV, Therapeutic study.
本研究旨在评估采用可吸收棒和克氏针治疗尺骨鹰嘴骨折和桡骨颈移位骨折的儿科患者的治疗效果。
本回顾性单中心研究纳入了31例年龄在3至13岁之间、采用可吸收棒和克氏针治疗尺骨鹰嘴骨折和桡骨颈移位骨折的患者(20例男性,11例女性)。所有桡骨颈骨折均为Judet IV型,尺骨鹰嘴骨折有17例C型和14例D型。随访时间为26至56个月(平均35.8个月)。首先采用Boyd入路复位尺骨鹰嘴骨折并用克氏针固定。此后,复位桡骨颈骨折并用可吸收棒固定。使用Mayo肘关节功能指数评分评估患者的功能结局。
根据Mayo肘关节功能指数评分,19例患者结果为优,8例为良,2例为中,2例为差。优良率为87.1%。Mayo肘关节功能指数评分平均为91.5分。3例患者术前出现桡神经损伤,术中进行了评估。无需进行神经修复,所有神经损伤均在3个月内恢复。
本研究表明,对于儿科患者的尺骨鹰嘴骨折和严重移位的桡骨颈骨折,采用Boyd入路切开复位并用可吸收棒和克氏针固定是可行的。
IV级,治疗性研究。