Rigatti Gabriel, Danesi Sérgio Roberto Canarim, Barbosa Rafaela Dias, Schreiner Douglas Backes
Departamento de Ortopedia e Traumatologia, Hospital Cristo Redentor, Grupo Hospitalar Conceição, Porto Alegre, RS, Brasil.
Ortopedia Pediátrica, Hospital Cristo Redentor, Grupo Hospitalar Conceição, Porto Alegre, RS, Brasil.
Rev Bras Ortop (Sao Paulo). 2024 Aug 1;59(4):e607-e612. doi: 10.1055/s-0044-1787765. eCollection 2024 Aug.
To perform a radiographic assessment of the quality of supracondylar fracture fixation by identifying the factors that have contributed to inadequate reduction and increased the chance of reduction loss during outpatient follow-up. The variables analyzed were as follows: fracture line, initial displacement, time of day the surgery was performed, and chosen fixation technique. Review of electronic medical records and radiographic evaluation of supracondylar fractures operated from January 2017 to December 2022. The radiograph assessment was based on the Baumann angle and the anterior humeral line. Determination of fixation quality was based on the number of cortices, crossing site, and wire divergence. We evaluated 194 cases, and postoperative reduction was poor in 17% of the subjects. Reduction loss occurred in 39 cases (20.10%), and 19 (48.7%) of these patients presented insufficient fixation ( = 0.002). Among the cases operated during the day, 12.5% lost the reduction compared with 32% of the patients who underwent surgery at night and early in the morning ( = 0.001). Reduction quality and postoperative fixation loss were closely related to technical errors and the time of day the surgery was performed.
通过识别导致复位不充分并增加门诊随访期间复位丢失几率的因素，对髁上骨折固定质量进行影像学评估。分析的变量如下：骨折线、初始移位、手术进行的时间以及所选择的固定技术。
回顾2017年1月至2022年12月期间接受手术的髁上骨折的电子病历并进行影像学评估。影像学评估基于鲍曼角和肱骨前线。固定质量的判定基于皮质骨数量、交叉部位和钢丝发散情况。
我们评估了194例病例，17%的受试者术后复位不佳。39例（20.10%）出现复位丢失，其中19例（48.7%）患者固定不充分（P = 0.002）。在白天进行手术的病例中，12.5%出现复位丢失，而在夜间和清晨进行手术的患者中这一比例为32%（P = 0.001）。
复位质量和术后固定丢失与技术失误以及手术进行的时间密切相关。
