Anhui Provincial Children's Hospital, Hefei, China.
The Fifth Clinical College of Anhui Medical University, Hefei, China.
Eur J Med Res. 2024 Jan 30;29(1):87. doi: 10.1186/s40001-024-01671-4.
To compare the clinical effects of intramedullary elastic reduction of the "de-sharpened Kirschner wire and traditional three-dimensional manipulation in the treatment of Gartland type III posterolateral supracondylar fracture of the humerus in children.
A retrospective cohort analysis was made on 106 cases of Gartland type III posterolateral supracondylar fracture of the humerus treated in the Department of Orthopaedics of a Children's Hospital from March 2020 to March 2022. According to different surgical technology, the patients were divided into two groups: intramedullary elastic reduction of the de-sharpened Kirschner wire group (experimental group, n = 50) and traditional three-dimensional manipulation group (control group, n = 56). The surgical operating time, intraoperative fluoroscopy times, postoperative Baumann angle changes, postoperative elbow function Flynn score, and complications were collected and compared between the two groups.
All the enrolled cases underwent surgery successfully and were followed-up at least 6 months. The surgical operating time of the experimental group was 32.88 ± 3.69 min and that of the control group was 45.56 ± 10.13 min, and the difference was statistically significant (P < 0.05). The intraoperative fluoroscopy times were 20.62 ± 5.41 times in the experimental group and 32.48 ± 8.20 times in the control group (P < 0.05). The change of Baumann angle in the experimental group after operation was 2.3 ± 1.3 and that in the control group was 6.0 ± 2.1 (P < 0.5). Elbow joint Flynn scoring standard to evaluate the curative effect: the excellent and good rate was 98.00% (49/50) in the experimental group and 92.86% (52/56) in the control group (P > 0.5). There were no complications such as osteomyelitis, compartment syndrome, iatrogenic vascular and nerve injury, and myositis ossificans in either group.
Good functional outcome can be obtained with both intramedullary elastic reduction of the de-sharpened Kirschner wire and traditional three-dimensional manipulation for Gartland type III posterolateral displaced supracondylar fracture of the humerus in children; however, the former does not need repeated manipulation, and the operation time is shorter, the number of intraoperative fluoroscopy is less, and the recovery of the Baumann angle is better.
比较髓内弹性去尖克氏针复位与传统三维手法复位治疗儿童 gartland Ⅲ型肱骨髁后外侧髁骨折的临床效果。
回顾性分析 2020 年 3 月至 2022 年 3 月在某儿童医院骨科治疗的 106 例 gartland Ⅲ型肱骨髁后外侧髁骨折患儿。根据不同的手术技术，将患者分为髓内弹性去尖克氏针复位组（实验组，n=50）和传统三维手法复位组（对照组，n=56）。收集并比较两组患者的手术操作时间、术中透视次数、术后 baumann 角变化、术后 elbow Flynn 评分和并发症。
所有入组病例均顺利完成手术，并至少随访 6 个月。实验组的手术操作时间为 32.88±3.69min，对照组为 45.56±10.13min，差异有统计学意义（P<0.05）。实验组术中透视次数为 20.62±5.41 次，对照组为 32.48±8.20 次（P<0.05）。实验组术后 baumann 角变化为 2.3±1.3，对照组为 6.0±2.1（P<0.5）。采用 elbow Flynn 评分标准评价疗效：实验组优良率为 98.00%（49/50），对照组为 92.86%（52/56）（P>0.5）。两组均无骨髓炎、骨筋膜室综合征、医源性血管神经损伤、骨化性肌炎等并发症。
髓内弹性去尖克氏针复位与传统三维手法复位治疗儿童 gartland Ⅲ型肱骨髁后外侧髁骨折均可获得良好的功能结果，但前者无需反复操作，手术时间更短，术中透视次数更少，baumann 角恢复更好。
