Department of Orthopaedics, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, 33 Longhu Waihuan East Road, Henan, Zhengzhou, 450018, China.
Department of Orthopaedics, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, 56 Nanlishi Road, Xicheng District, Beijing, China.
BMC Musculoskelet Disord. 2024 Aug 29;25(1):683. doi: 10.1186/s12891-024-07822-2.
This study investigated the clinical and functional outcomes of children with distal both-bone forearm fractures treated by fixation of the radius only compared to fixation of both the radius and ulna.
A total of 71 patients from two centres with distal both-bone forearm fractures (30 in the ulna-yes group, 41 in the ulna-no group) who underwent closed reduction and percutaneous pinning treatment were retrospectively analysed. Operation duration, number of fluoroscopic exposures, loss of reduction rate and angulation based on radiographic assessment were compared between the two groups. Evaluation of wrist function including Gartland-Werley Score and Mayo Wrist Score were compared at the last follow-up.
Ulna angulation upon bone healing on the posteroanterior and the lateral plane of ulna-no group (6.11 ± 1.56°; 6.51 ± 1.69°) was significantly greater than that of ulna-yes group (4.49 ± 1.30°; 5.05 ± 2.18°) (p < 0.05). No significant difference was found in the loss of reduction rate between ulna-yes group (6.67%, 2/30) and the ulna-no group (4.88%, 2/41) (p > 0.05). At last follow-up, no significant difference was found between the Gartland-Werley Scores of the ulna-yes group (1.83 ± 3.25, range: 0-16) and ulna-no group (1.85 ± 2.72, range: 0-11.5) (p > 0.05). No significant difference was found between the Mayo Wrist Scores of the ulna-yes group (92.60 ± 6.20) and ulna-no group (92.15 ± 7.58) (p > 0.05).
For distal both-bone forearm fractures in children, fixation of only the radius appears to be a viable method with equivalent clinical outcomes compared to fixation of both the radius and ulna.
本研究旨在对比单纯固定桡骨与同时固定桡骨和尺骨治疗儿童尺桡骨远端双骨折的临床和功能结果。
回顾性分析了来自两个中心的 71 例尺桡骨远端双骨折（尺骨固定组 30 例，尺骨不固定组 41 例）患者，均行闭合复位经皮克氏针固定治疗。比较两组患者的手术时间、透视次数、复位丢失率和影像学评估的成角。末次随访时，比较两组腕关节功能（Gartland-Werley 评分和 Mayo 腕关节评分）。
尺骨不固定组的尺骨前后位（6.11±1.56°；6.51±1.69°）和侧位（6.11±1.56°；6.51±1.69°）愈合时的成角明显大于尺骨固定组（4.49±1.30°；5.05±2.18°）（p<0.05）。尺骨固定组（6.67%，2/30）和尺骨不固定组（4.88%，2/41）的复位丢失率无显著差异（p>0.05）。末次随访时，尺骨固定组的 Gartland-Werley 评分（1.83±3.25，范围：0-16）与尺骨不固定组（1.85±2.72，范围：0-11.5）无显著差异（p>0.05）。尺骨固定组的 Mayo 腕关节评分（92.60±6.20）与尺骨不固定组（92.15±7.58）无显著差异（p>0.05）。
对于儿童尺桡骨远端双骨折，单纯固定桡骨似乎是一种可行的方法，其临床结果与同时固定桡骨和尺骨相当。
