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沙特阿拉伯某地区医院小儿肱骨髁上骨折固定术的疗效:一项回顾性研究

Outcomes of Pediatric Supracondylar Humerus Fracture Fixation in a District Hospital in Saudi Arabia: A Retrospective Study.

作者信息

Aldhilan Mansour M, Tella Azeez O

机构信息

Orthopedic Surgery, Al Rass General Hospital, Ministry of Health, Al Rass, SAU.

Orthopedics, Samtah General Hospital, Jazan, SAU.

出版信息

Cureus. 2025 May 12;17(5):e83967. doi: 10.7759/cureus.83967. eCollection 2025 May.

Abstract

Background Supracondylar humerus fractures are among the most common pediatric fractures, and treatment can be challenging. Closed reduction and percutaneous pinning is the recommended treatment for displaced fractures. This study aimed to review the management of supracondylar humerus fractures at a district general hospital and to document our experience. Materials and methods We conducted a retrospective analysis of electronic medical records of pediatric patients who underwent surgical treatment of supracondylar humerus fractures treated over a 30-month period. Data collected included demographics, mechanism of injury, fracture type, modified Gartland classification, surgical management, clinical outcomes, and complications. Results A total of 36 patients met the inclusion criteria. The mean age was 5.2 ± 2.6 years (range 1-12 years), with a male-to-female ratio of 1.6:1. Extension-type injuries were observed in 35 patients (97.2%) and flexion-type in one patient (2.8%). According to the modified Gartland classification, extension-type fractures were distributed as follows: type II (34.3%), type III (60%), and type IV (5.7%). Most patients (91.7%) were treated with closed reduction and percutaneous pinning. The overall complication rate was 11.2%, with superficial surgical site infection being the most common (5.6%). One patient (2.8%) developed postoperative ulnar nerve palsy, attributed to medial pin placement. Based on Flynn's criteria, all patients achieved satisfactory outcomes at the final follow-up. Conclusion Our findings are consistent with those reported in the literature. Despite limited resources, closed reduction and percutaneous pinning remain the gold standard for managing displaced supracondylar humerus fractures, yielding satisfactory clinical outcomes and an acceptable complication profile.

摘要

背景

肱骨髁上骨折是最常见的小儿骨折之一,其治疗具有挑战性。闭合复位经皮穿针固定是移位骨折的推荐治疗方法。本研究旨在回顾一家地区综合医院对肱骨髁上骨折的治疗情况并记录我们的经验。

材料与方法

我们对在30个月期间接受肱骨髁上骨折手术治疗的儿科患者的电子病历进行了回顾性分析。收集的数据包括人口统计学资料、损伤机制、骨折类型、改良Gartland分类、手术治疗、临床结果和并发症。

结果

共有36例患者符合纳入标准。平均年龄为5.2±2.6岁(范围1 - 12岁),男女比例为1.6:1。35例患者(97.2%)为伸直型损伤,1例患者(2.8%)为屈曲型损伤。根据改良Gartland分类,伸直型骨折分布如下:Ⅱ型(34.3%),Ⅲ型(60%),Ⅳ型(5.7%)。大多数患者(91.7%)接受了闭合复位经皮穿针固定治疗。总体并发症发生率为11.2%,其中手术部位浅表感染最为常见(5.6%)。1例患者(2.8%)发生术后尺神经麻痹,归因于内侧穿针位置。根据Flynn标准,所有患者在末次随访时均获得满意结果。

结论

我们的研究结果与文献报道一致。尽管资源有限,但闭合复位经皮穿针固定仍然是治疗移位肱骨髁上骨折的金标准,可产生满意的临床结果和可接受的并发症情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ccc/12159274/a3613e0a8afa/cureus-0017-00000083967-i01.jpg

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