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首页> 外文期刊>Open Journal of Urology >Pediatric Supracondylar Humerus Fractures: Are Medial Pins Indicated?
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Pediatric Supracondylar Humerus Fractures: Are Medial Pins Indicated?

机译：小儿Su上肱骨骨折：是否标明了内侧销？

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Background: Pediatric supracondylar humerus fractures are the most common elbow fractures in children. Operative management includes closed reduction and placement of 2 to 3 laterally based pins. Occasionally, a medial pin is used to create a crossed fixation pattern, despite risk of nearly 10% iatrogenic ulnar nerve injury. The objective of this study was to assess the trends and outcomes in the operative management of pediatric supracondylar humerus fractures at a level one academic trauma center. Materials & Methods: A retrospective review was performed on all children sustaining a Gartland type II or III supracondylar humerus fractures treated by closed or open reduction and percutaneous pinning in 2006-2008 and 2009-2011 at a level one academic trauma center by two of the authors (JTR, LMT). Pin placement patterns were evaluated and compared based on year performed. Outcomes measured were rates of ulnar nerve symptoms, non-union, re-operation, and varus malalignment. Data analysis was performed using a Fisher exact test on STATA software. Results: A total of 49 patients met inclusion criteria. Of 22 patients treated in 2006-2008, 5 (23%) were type II and 17 (77%) were type III. From 2009-2011, 16 (59%) were type II and 11 (41%) were type III. Comparison of pinning pattern in type II fractures between 2006-2008 and 2009-2011 did not indicate statistical significance (p = 0.429). Comparison of pinning pattern in type III fractures during the same time period did show that there was a statistically significant decrease (p = 0.010) in the number of cross pin fixations. There were no ulnar nerve injuries, non-unions, re-operations, or varus malalignment in any patient on final follow-up. Conclusion: This study shows that there has been a significant decrease in cross pin fixation for pediatric type III supracondylar humerus fractures with equivalent clinical outcomes at a Level I trauma center. Furthermore, performing lateral pinning for type III fractures has eliminated the risk of iatrogenic ulnar nerve injury. Level of Evidence: Level III—Retrospective cohort study.
机译：背景：小儿con上肱骨骨折是儿童中最常见的肘部骨折。手术管理包括闭合复位和放置2到3个横向销。有时，尽管有将近10％的医源性尺神经损伤的风险，也可以使用内侧销来产生交叉固定模式。这项研究的目的是评估一级学术创伤中心的小儿con上肱骨骨折手术治疗的趋势和结果。材料与方法：回顾性研究2006-2008年和2009-2011年在一级学术创伤中心接受闭式或切开复位并经皮固定的所有患有Gartland II型或III型G上肱骨骨折的儿童。作者（JTR，LMT）。根据执行年份评估并比较了引脚放置模式。测量的结果是尺神经症状，不愈合，再次手术和内翻畸形的发生率。使用STATA软件上的Fisher精确测试进行数据分析。结果：总共49例患者符合入选标准。在2006-2008年接受治疗的22例患者中，II型5例（23％），III型17例（77％）。从2009年至2011年，II型为16（59％），III型为11（41％）。在2006-2008年与2009-2011年间比较II型骨折的钉扎模式没有统计学意义（p = 0.429）。比较同期在III型骨折中的固定方式，确实显示出交叉固定销的数量在统计学上有显着下降（p = 0.010）。在最终随访中，所有患者均未发生尺神经损伤，骨不愈合，再次手术或内翻畸形。结论：这项研究表明，在I级创伤中心，小儿III型con上肱骨骨折的交叉销固定明显减少，临床效果相当。此外，对III型骨折进行侧向钉扎消除了医源性尺神经损伤的风险。证据级别：III级-回顾性队列研究。

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