Department of Pediatric Orthopaedics, Sichuan Provincial Orthopaedic Hospital, No. 132 West First Section First Ring Road, Chengdu, 610041, Sichuan, China.
Department of Otolaryngology Head and Neck Surgery, First Hospital of Shanxi Medical University, Taiyuan, 030000, Shanxi, China.
J Orthop Surg Res. 2024 Feb 2;19(1):113. doi: 10.1186/s13018-024-04592-4.
This study employs an innovative closed reduction approach to treat pediatric "Irreducible Supracondylar Humerus Fractures" with the goal of demonstrating its practical application compared to conventional methods.
This study sampled 146 surgically treated cases of "Irreducible Supracondylar Humerus Fractures" in our department. After applying inclusion and exclusion criteria, 120 children were selected and divided into two groups based on treatment methods. Group 1 underwent Closed Reduction and Percutaneous Pinning (CRPP), while Group 2 received treatment using the Kirschner Wire Prying and Leverage Technique alongside CRPP. The relevant data to the study were collected and assessed during the follow-up period.
Results indicate that Group 2 demonstrated significantly shorter operative times and fewer instances of intraoperative fluoroscopy compared to Group 1. Furthermore, the percentage of cases requiring open reduction was notably higher in Group 1 than in Group 2. The analysis also identified age, BMI, time from injury to surgery, and the initial deviation of the distal fragment as independent risk factors associated with the failure of closed reduction. The integration of CRPP with the Kirschner Wire Prying and Leverage Technique emerges as a safe and effective strategy for managing "Irreducible Supracondylar Humerus Fractures." This innovative approach not only reduces operative time and intraoperative fluoroscopy needs but also diminishes the reliance on open reduction without compromising safety.
本研究采用一种创新的闭合复位方法治疗小儿“不可复位的肱骨髁上骨折”,旨在展示与传统方法相比的实际应用。
本研究在我院对 146 例手术治疗的“不可复位的肱骨髁上骨折”进行了抽样研究。经过纳入和排除标准后,选择了 120 例儿童,并根据治疗方法将其分为两组。第 1 组采用闭合复位和经皮克氏针固定(CRPP),第 2 组采用克氏针撬拨和杠杆技术联合 CRPP 治疗。在随访期间收集并评估了与研究相关的数据。
结果表明,与第 1 组相比,第 2 组的手术时间明显缩短,术中透视次数减少。此外,第 1 组需要开放复位的病例比例明显高于第 2 组。分析还确定年龄、BMI、受伤至手术的时间以及远端碎片的初始偏移是与闭合复位失败相关的独立危险因素。CRPP 与克氏针撬拨和杠杆技术相结合是一种安全有效的治疗“不可复位的肱骨髁上骨折”的方法。这种创新方法不仅缩短了手术时间和术中透视的需要,而且减少了对开放复位的依赖,同时不影响安全性。