我们采用改良撬拨复位技术治疗难复性肱骨髁上骨折的经验。

Our experience with a modified prying-up technique for closed reduction of irreducible supracondylar humeral fractures.

机构信息

Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, 3 Kangxin Road, Western District, Zhongshan, 528400, Guangdong, China.

Guangzhou University of Chinese Medicine, 12 Airport Road, Baiyun District, Guangzhou, 510006, Guangdong, China.

出版信息

Sci Rep. 2024 Oct 4;14(1):23048. doi: 10.1038/s41598-024-74467-5.

Abstract

Satisfactory reduction of some displaced pediatric supracondylar humerus fractures is not achievable via closed reduction, thus necessitating open procedure, which increases the incidence of complications. Using percutaneous prying-up technique to assist closed reduction may reduce the requirement for transform to an open operation. We retrospectively reviewed displaced pediatric supracondylar humerus fractures treated by the same surgeon from September 2021 to January 2024,with 134 subjects meeting criteria for inclusion. These children were divided into two groups. In Group A(n = 61),the prying-up technique was used to assist with closed reduction of fractures. Group B(n = 73) included fractures treated with conventional manual traction. To balance group size,12 fractures from group A were randomly removed, leaving a final 61 patients in each group. Demographics, operative time, the rate of failed closed reduction, complications and radiographic results were analyzed. The operative time was significantly less in Group A as compared with Group B(mean difference, - 7.22; [95% confidence interval (CI), - 8.49 to - 5.94]; p < 0.001). The rate of failed closed reduction were significantly lower in Group A as compared to Group B(2 of 61 vs. 10 of 61, p = 0.015).However, we found no difference in terms of the radiographic results and complications between the two groups(p > 0.05). percutaneous prying-up technique significantly improves the efficiency of surgery and reduces rate of failed closed reduction of supracondylar humeral fractures in pediatric patients. Level III, retrospective comparative study.See Guidelines for Authors for a complete description of levels of evidence.

摘要

经皮撬拨技术辅助闭合复位治疗儿童移位性肱骨髁上骨折

目的

经皮撬拨技术辅助闭合复位可提高儿童移位性肱骨髁上骨折的复位成功率,减少手术时间。

方法

回顾性分析 2021 年 9 月至 2024 年 1 月由同一医生治疗的 134 例儿童移位性肱骨髁上骨折患者的临床资料,根据复位方法的不同分为撬拨组(A 组,n=61)和传统手法复位组(B 组,n=73)。A 组采用经皮撬拨技术辅助闭合复位,B 组采用传统手法复位。为平衡组间差异,将 A 组中 12 例骨折随机剔除,最终每组各 61 例。比较两组的手术时间、复位失败率、并发症发生率及影像学结果。

结果

与 B 组相比,A 组的手术时间明显缩短(平均差值,-7.22;95%置信区间,-8.49 至-5.94;p<0.001),复位失败率明显降低(2/61 与 10/61,p=0.015),但两组的影像学结果及并发症发生率差异无统计学意义(p>0.05)。

结论

经皮撬拨技术辅助闭合复位可提高儿童移位性肱骨髁上骨折的复位成功率,减少手术时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cefb/11452542/e21f2150b1c8/41598_2024_74467_Fig1_HTML.jpg

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