Topping R E, Blanco J S, Davis T J
Department of Orthopedic Surgery, University of Virginia Health Sciences Center, Charlottesville, USA.
J Pediatr Orthop. 1995 Jul-Aug;15(4):435-9. doi: 10.1097/01241398-199507000-00004.
The radiographs and patient charts of 47 children treated with closed reduction and percutaneous pin fixation of displaced supracondylar humerus fractures were reviewed. Twenty-seven fractures were fixed with crossed medial and lateral pins. Twenty fractures were treated with two parallel laterally placed pins. Baumann's angle on the anteroposterior elbow film and the humerocapitellar angle on the lateral elbow film were independently measured by the three authors on initial postoperative films and on films taken at the time of pin removal. No statistically significant differences regarding maintenance of reduction were found when comparing the two fixation groups. There were two complications in the medial pin group (one cubitus varus and one ulnar nerve injury) and none in the lateral-pin group. We conclude that crossed-pin fixation offers no clinically significant advantage over two laterally placed pins in the treatment of supracondylar humerus fractures.
回顾了47例采用闭合复位经皮穿针固定治疗的儿童肱骨髁上移位骨折的X线片和患者病历。27例骨折采用内外侧交叉克氏针固定。20例骨折采用两根平行的外侧克氏针治疗。三位作者分别在术后初期及拔针时拍摄的X线片上独立测量了肘关节前后位片上的鲍曼角（Baumann's angle）和肘关节侧位片上的肱骨头-肱骨小头角（humerocapitellar angle）。比较两组固定方式时，在维持复位方面未发现统计学上的显著差异。内侧克氏针组出现了2例并发症（1例肘内翻和1例尺神经损伤），外侧克氏针组未出现并发症。我们得出结论，在治疗肱骨髁上骨折时，交叉克氏针固定与两根外侧克氏针固定相比，在临床上没有显著优势。
