Yang Jun,Gao Hui,Hou Pengcheng,et al.Clinical efficacy of closed reduction and percutaneous Kirschner wire fixation for lateral humeral condyle fracture in children and analysis of influencing factors of complications: a report of 94 cases[J].Journal of Clinical Pediatric Surgery,2025,(02):165-171.[doi:10.3760/cma.j.cn101785-202406058-011]
Clinical efficacy of closed reduction and percutaneous Kirschner wire fixation for lateral humeral condyle fracture in children and analysis of influencing factors of complications: a report of 94 cases
- Keywords:
- Fracture of Lateral Humeral Condyle; Closed Fracture Reduction; Fracture Fixation; Internal; Treatment Outcome; Postoperative Complications; Correlation of Data
- Abstract:
- Objective To retrospectively review the clinical data of 94 children with lateral humeral condylar fracture (LHCF) undergoing closed reduction and percutaneous Kirschner wire fixation,observe its curative effect and complications and examine the related factors influencing its complications. Methods From March 2020 to June 2023,the relevant clinical data were retrospectively reviewed for 94 LHCF children undergoing closed reduction and percutaneous Kirschner wire fixation at Department of Orthopedics,Yingtan No.184 Hospital.Operative duration,volume of intraoperative blood loss,hospitalization stay,body mass index (BMI),fracture site,injury mode,bone mineral density (BMD),initial displacement of fracture,operation opportunity and time to start functional exercise post-operation were recorded.According to the presence or absence of needle infection,cubitus varus and delayed healing,they were assigned into two groups of normal (n=84) and complication (n=10).Univariate factor analysis and multivariate Logistic regression model were utilized for examining the related factors affecting postoperative complications. Results Average operative duration was (56.62±8.95) min,average volume of intraoperative blood loss (2.34±0.36) ml,average hospitalization stay (4.93±1.15) day and excellent/good rate 90.43%(85/94).During follow-ups of (6-12) month,complications occurred at an overall incidence of 10.64%(10/94),including nail infection (n=4),cubitus varus (n=1),cubitus valgus (n=2),delayed healing (n=1) and joint stiffness (n=2).Univariate analysis revealed BMI,BMD,initial displacement of fracture,timing of operation and time to start functional exercise post-operation were all correlated with postoperative complications (P<0.05).Multivariate analysis indicated that BMD,initial displacement of fracture,timing of operation and time of starting functional exercise post-operation were independent influencing factors for postoperative complications (P<0.05). Conclusions Closed reduction and percutaneous Kirschner wire fixation for LHCF offer the advantages of shorter operative duration,minimal hemorrhage,shorter hospitalization stay,high excellent/good rate and fewer complications.And the occurrence of postoperative complications is correlated with BMD,initial displacement of fracture,timing of operation and time to start functional exercise post-operation.
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Memo
收稿日期:2024-6-27。
基金项目:2022年全军高层次人才项目([2022]17-02)
通讯作者:周江军,Email:zjjortho@163.com