Higuchi Douglas Hideo, de Oliveira Gabriel Alencar, Alves João Paulo, Lebedenco Lucas, Dobashi Eiffel Tsuyoshi
Universidade Federal de São Paulo - UNIFESP, Escola Paulista de Medicina, Departamento de Ortopedia e Traumatologia, São Paulo, SP, Brasil.
Acta Ortop Bras. 2024 Aug 2;32(3):e278420. doi: 10.1590/1413-785220243203e278420. eCollection 2024.
To compare the outcomes of surgical stabilization of pediatric supracondylar humeral fractures with the use of crossed Kirschner wires versus divergent lateral pinning wires.
This is a systematic review with meta-analysis carried out by searching the MEDLINE/PubMed, Science Direct and Scielo databases. In these, the search for journals was carried out between January and August 2023, where 695 studies were found. To assess the quality of the studies, the Jadad and the MINORS scales were used.. The selection and reading of relevant articles were carried out by the researchers and 11 studies met the selection criteria.
From the 11 selected studies, 963 patients who met the criteria for the surgical treatment of these fractures were grouped. After the statistical analysis, we found that the ulnar nerve injury had a higher incidence when the crossed-K wire technique was used; and the lateral fixation is safer for the ulnar nerve.
Both fixation techniques determine good functional results. However, fixation with lateral Kirschner wires proves to be safer considering the risk of iatrogenic injury to the ulnar nerve. Crossed-K wire fixation is more effective in terms of stability and maintenance of fracture reduction.
比较使用交叉克氏针与外侧发散式穿针技术对小儿肱骨髁上骨折进行手术固定的效果。
这是一项通过检索MEDLINE/PubMed、Science Direct和Scielo数据库进行的系统评价及荟萃分析。在这些数据库中,于2023年1月至8月期间检索期刊,共找到695项研究。为评估研究质量,使用了Jadad量表和MINORS量表。相关文章的筛选和阅读由研究人员进行,11项研究符合入选标准。
从11项入选研究中,将963例符合这些骨折手术治疗标准的患者进行分组。经过统计分析,我们发现使用交叉克氏针技术时尺神经损伤的发生率较高;而外侧固定对尺神经更安全。
两种固定技术均能取得良好的功能效果。然而,考虑到尺神经发生医源性损伤的风险,外侧克氏针固定更为安全。交叉克氏针固定在骨折稳定性和复位维持方面更有效。