Iwata Hidetoshi, Sakai Go, Katsuda Yasuhiro, Funahashi Shinji, Shibata Jun, Hattori Yusuke, Okamoto Hideki, Yamada Kunio, Sekiya Isato, Murakami Hideki, Kawaguchi Yohei
Department of Orthopedic Surgery, Kainan Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Yatomi, Japan.
Department of Orthopedic Surgery, Komaki City Hospital, Komaki, Japan.
Eur J Orthop Surg Traumatol. 2025 Jun 8;35(1):237. doi: 10.1007/s00590-025-04361-x.
Supracondylar humeral fractures are common in children and require early surgical intervention to prevent complications. Although percutaneous pinning is a standard treatment, the optimal pinning technique remains controversial. Therefore, this study aimed to compare the outcomes of lateral and through-the-elbow joint pinning (group J) and cross-pinning (group C) for paediatric supracondylar humeral fractures.
This retrospective analysis included paediatric patients with supracondylar humeral fractures treated at two trauma centres. Group J underwent lateral and through-the-elbow joint pinning, whereas group C underwent cross-pinning. Clinical data, including demographics, surgical details, complications, and radiological assessments, were collected and compared between the groups.
Both groups exhibited similar demographic and clinical characteristics, except for the timing of post-operative Kirschner wire removal. No significant differences were found in elbow range of motion or the incidence of complications between groups J and C. Radiologically, there were no significant differences in fracture union or reduction loss between the groups, although group C showed larger Baumann and tilting angles than group J.
Lateral and through-the-elbow joint pinning demonstrated outcomes comparable to those of cross-pinning in paediatric supracondylar humeral fractures. Both techniques resulted in minimal reduction loss, with no cases of ulnar nerve palsy. These findings suggest that lateral and through-the-elbow joint pinning is a viable alternative to cross-pinning, potentially reducing the risk of iatrogenic ulnar nerve injury.
肱骨髁上骨折在儿童中较为常见，需要早期手术干预以预防并发症。尽管经皮穿针固定是一种标准治疗方法，但最佳的穿针技术仍存在争议。因此，本研究旨在比较外侧及经肘关节穿针固定（J组）与交叉穿针固定（C组）治疗小儿肱骨髁上骨折的疗效。
本回顾性分析纳入了在两个创伤中心接受治疗的小儿肱骨髁上骨折患者。J组采用外侧及经肘关节穿针固定，而C组采用交叉穿针固定。收集并比较两组的临床资料，包括人口统计学数据、手术细节、并发症及影像学评估结果。
除术后克氏针取出时间外，两组患者的人口统计学和临床特征相似。J组和C组在肘关节活动范围或并发症发生率方面未发现显著差异。在影像学方面，两组在骨折愈合或复位丢失方面无显著差异，尽管C组的鲍曼角和倾斜角比J组大。
在小儿肱骨髁上骨折中，外侧及经肘关节穿针固定的疗效与交叉穿针固定相当。两种技术导致的复位丢失均最小，且无尺神经麻痹病例。这些结果表明，外侧及经肘关节穿针固定是交叉穿针固定的一种可行替代方法，可能会降低医源性尺神经损伤的风险。
