新型辅助复位经皮内固定儿童肱骨髁上骨折

A novel reduction device assisted percutaneous fixation of humeral supracondylar fractures in children

摘要:

[目的] 探讨自行制作的新型复位固定装置辅助经皮固定儿童肱骨髁上骨折的临床疗效。[方法] 回顾性分析 2019 年 6 月—2022 年 1 月本院收治的 85 例伸直型肱骨髁上骨折患者临床资料。根据医患沟通结果，43 例采用新型辅助复位固定装置协助闭合复位经皮克氏针交叉固定 （新型组），42 例采用传统闭合复位经皮克氏针交叉固定 （传统组）。比较两组临床及影像结果。[结果] 新型组手术时间 [(36.0±6.6)min vs (55.7±8.5)min, P＜0.001] 和术中透视次数 [(19.8±3.2)次 vs (36.7±6.3)次, P＜ 0.001] 均显著优于传统组。两组术后并发症发生率差异无统计学意义 （P＞0.05）。随访时间平均 （6.7±3.2） 个月，末次随访， 两组 Flynn 评级差异无统计学意义 （P＞0.05）。影像方面，末次随访时，新型组的提携角显著大于传统组 [11.2±1.4)° vs (8.0± 1.3)°, P＜0.001]，但是，两组间 Baumann 角的差异无统计学意义 （P＞0.05），[结论] 新型辅助复位固定装置结构简单，可缩短儿童肱骨髁上骨折手术时间，减少术中透视次数。

Abstract:

[Objective] To evaluate the clinical efficacy of a novel reductor developed by ourself used for maintaining reduction during percutaneous fixation of humeral supracondylar fractures in children. [Methods] A total of 85 children received percutaneous fixation with Kirschner wire for the extended humeral supracondylar fractures in our hospital from June 2019 to June 2022. According to doctor-patient communication, 43 children received the novel reductor assisted reduction and percutaneous fixation with Kirschner wire (the novel group), while the other 42 patients underwent the traditional closed reduction and percutaneous fixation (the traditional group). The clinical and im- aging consequences were compared between the two groups. [Results] The novel group proved significantly superior to the traditional group in terms of operative time [(36.0±6.6)min vs (55.7±8.5)min, P＜0.001] and intraoperative fluoroscopy [(19.8±3.2)times vs (36.7±6.3)times, P＜ 0.001], although there was no significant difference in the incidence of postoperative complications between the two groups (P＞0.05). At the latest follow-up lasted for (6.7±3.2) months on a mean., there was no significant difference in Flynn grade between the two groups (P＞0.05). The novel group had significantly greater carrying angler than the traditional group [(11.2±1.4)° vs (8.0±1.3)°, P＜0.001], despite of that the Baumann angle was not statistically significant between them at the latest follow-up (P＞0.05). [Conclusion] This novel reduction device is simple in structure, which does shorten the operative time of percutaneous fixation and reduce the number of intraoperative fluoroscopy for humeral supracondylar fractures in children.