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首页> 外文期刊>Journal of orthopaedics and traumatology: official journal of the Italian Society of Orthopaedics and Traumatology >Management of displaced radial neck fractures in children: percutaneous pinning vs. elastic stable intramedullary nailing
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Management of displaced radial neck fractures in children: percutaneous pinning vs. elastic stable intramedullary nailing

机译：儿童radial骨颈移位骨折的处理：经皮固定与弹性稳定的髓内钉固定

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class="Heading">Background class="Para">The treatment of radial neck fractures in children varies according to the displacement, angulation, and skeletal maturity. There is a general agreement that displaced radial neck fractures with more than 30° angulations (Judet type III and IV fractures) should be surgically treated. There are several treatment possibilities for Judet type III and IV fractures including percutaneous pin reduction, elastic stable intramedullary nailing (ESIN), and open reduction with or without internal fixation. In this retrospective study we compared the clinical and radiographical outcomes, and complications following intramedullary versus percutaneous pinning in displaced radial neck fractures in children. class="Heading">Materials and methods class="Para">Between 2000 and 2011, 20 patients were treated using closed reduction: in 12 cases we used percutaneous pinning, and in 8 cases we used ESIN. According to Judet classification the two groups were composed as follows: 10 (77?%) type III and 3 (23?%) type IV fractures in the percutaneous pinning group; 4 (57?%) type III, and 3 (43?%) type IV fractures in the ESIN group. class="Heading">Results class="Para">After an average of 42?months, excellent results in Mayo elbow performance scores (MEPS) were obtained in 71 and 69?% of ESIN and percutaneous pinning groups respectively, with good results in the remaining cases apart from one fair case (8?%) in the percutaneous pinning group. After a radiological evaluation, all fractures healed in excellent or good alignment. When comparing the two groups, the subjects treated with the ESIN technique had higher range of motion (ROM) in flexion, extension and pronation. No patients developed complications, except three cases of asymptomatic enlargements of the radial head, reported only in the percutaneous pinning group. class="Heading">Conclusion class="Para">In this research the clinical outcome, assessed with the MEPS, and the radiological alignment, were comparable between the subjects that were treated with percutaneous pinning and those with ESIN techniques; whereas the ESIN technique demonstrated higher ROM in flexion, extension and pronation. The ESIN technique seems to be the ideal approach both for the higher ROM values and for the absence of complications.
机译：class =“ Heading”>背景 class =“ Para”>对儿童radial骨颈骨折的治疗因位移，成角度和骨骼成熟而异。普遍同意，应通过外科手术治疗角度超过30°的放射状radial骨颈骨折（Judet III型和IV型骨折）。 Judet III和IV型骨折有几种治疗可能性，包括经皮针复位，弹性稳定的髓内钉（ESIN）以及有或没有内固定的开放复位。在这项回顾性研究中，我们比较了儿童移位型neck骨颈骨折的临床和影像学结果以及髓内钉与经皮钉扎后的并发症。 class =“ Heading”>材料和方法 class = “ Para“>在2000年至2011年之间，采用闭合复位术治疗了20例患者：在12例中，我们采用了经皮钉扎，在8例中，我们采用了ESIN。根据Judet分类法，两组的组成如下：经皮钉扎组10例（77％）III型骨折和3例（23 %%）IV型骨折。 ESIN组中有4例（57％）III型骨折和3例（43 %%）IV型骨折。 class =“ Heading”>结果 class =“ Para”>之后平均42个月，ESIN组和经皮固定组分别获得71％和69％的Mayo肘关节成绩得分（MEPS）优异的结果，在其余情况下，除1例一般情况（8％）以外，均取得了良好的效果在经皮固定组中。放射学评估后，所有骨折均以良好或良好的对位愈合。比较两组时，用ESIN技术治疗的受试者的屈伸，伸直和内旋运动范围（ROM）更大。除了三例cases骨头无症状性肿大，仅在经皮钉扎组中没有患者发生并发症。 class =“ Heading”>结论 class =“ Para”> In这项研究的临床结果（经MEPS评估）和放射线比对在经皮钉扎治疗和ESIN技术治疗的受试者之间具有可比性。而ESIN技术则显示出较高的ROM屈曲，伸展和内旋。对于较高的ROM值和没有并发症的情况，ESIN技术似乎都是理想的方法。

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