Zhang Jingyuan, Cao Hong
Department of Traumatic Orthopedics, Renmin Hospital, Hubei University of Medicine, Shiyan, China.
Front Pediatr. 2024 Nov 1;12:1456136. doi: 10.3389/fped.2024.1456136. eCollection 2024.
This study describes the efficacy of applying the prying lever technique to distal radial metaphyseal symphysis diaphysis joining region (DMP) fractures in children, and reports that the technique has an ameliorative effect on the phenomenon of delayed healing and non-union that occurs after surgery for fractures in the DMP region.
The medical records of 72 children with fractures in the DMP region, treated between December 2017 and December 2023, were retrospectively analyzed. The patients were randomly assigned to either the cut-and-displace group ( = 36) or the pry-and-lever group ( = 36). Both groups were monitored for time to fracture healing, incidence of delayed or non-union, radiologic outcomes, complications, and functional assessments using the EQ-5D, DASH, and VAS scales.
The follow-up period ranged from 3 to 5 years, with a mean of 26.5 months. After 6 months of follow-up, the incidence of delayed/non-union of fractures was 2.7% and 16.6% in the study and control groups, respectively, and the incidence of delayed healing was significant ( < 0.05) in both groups. Additional manipulations or complications caused by delayed healing or non-union were also significantly less in the study group than in the control group. The EQ-5D scale was used to compare the level of surgical satisfaction between the two groups, and the study group had a higher level of satisfaction. Carpal function was significantly improved in both groups compared to the preoperative period, scored using the DASH scale ( > 0.05). Postoperative pain level was scored using VAS ( < 0.05).
The prying lever technique has the advantages of low impact on periosteal blood supply, simple operation, and fast recovery, which makes it a worthwhile attempt of minimally invasive reduction of fractures in the DMP region in children.
本研究描述了将撬拨技术应用于儿童桡骨远端干骺端骨骺联合区（DMP）骨折的疗效，并报告该技术对DMP区骨折术后出现的延迟愈合和不愈合现象具有改善作用。
回顾性分析2017年12月至2023年12月期间治疗的72例DMP区骨折儿童的病历。将患者随机分为切开复位组（n = 36）或撬拨组（n = 36）。使用EQ - 5D、DASH和VAS量表对两组患者的骨折愈合时间、延迟或不愈合发生率、影像学结果、并发症及功能评估进行监测。
随访时间为3至5年，平均26.5个月。随访6个月后，研究组和对照组骨折延迟/不愈合发生率分别为2.7%和16.6%，两组延迟愈合发生率差异有统计学意义（P < 0.05）。研究组因延迟愈合或不愈合导致的额外操作或并发症也明显少于对照组。使用EQ - 5D量表比较两组手术满意度水平，研究组满意度更高。与术前相比，两组腕关节功能均显著改善，采用DASH量表评分（P > 0.05）。术后疼痛程度采用VAS评分（P < 0.05）。
撬拨技术对骨膜血供影响小、操作简单、恢复快，是儿童DMP区骨折微创复位的一项值得尝试的技术。
