Xiao Yuan,Zhou Ying,Liu Xin,et al.Clinical efficacies of open reduction plus internal fixation of cross Kirschner wire for difficult-to-reduce distal humeral epiphysis separations[J].Journal of Clinical Pediatric Surgery,,20():56-59.[doi:10.12260/lcxewkzz.2021.01.011]
Clinical efficacies of open reduction plus internal fixation of cross Kirschner wire for difficult-to-reduce distal humeral epiphysis separations
- Keywords:
- Humeral Fractures/SU; Epiphyses/IN; Fracture Fixation; Internal; Treatment Outcome; Postoperative Complications
- CLC:
- R726.8;R682.3;R726.1
- Abstract:
- Objective To explore the clinical efficacy of open reduction plus internal fixation of cross Kirschner wire for difficult-to-reduce distal humeral physeal separation in children.Methods A total of 26 cases were recruited from our emergency clinic from January 2015 to July 2017.After failing to achieve satisfactory reduction by gentle closed reduction under general anesthesia plus preoperative brachial plexus anesthesia,all of them immediately underwent open reduction plus internal fixation of cross Kirschner wire via a lateral approach.At 3 weeks post-operation,plaster was removed and followed by active functional exercises.Results During an average follow-up period of 25(8-42) months,the Flynn criteria were employed for evaluating clinical efficacy.The outcomes were excellent (n=19),decent (n=5),fair (n=2) and poor (n=0).The excellent and decent rate was 92%.Conclusion Through open reduction and internal fixation of cross Kirschner wire,hard-to-reduce distal humeral physeal separations may be treated satisfactorily with maximal anatomical reduction,lower cubitus varus rate and excellent recovery of elbow function.
References:
1 Gilbert SR,Conklin MJ.Presentation of distal humerus physeal separation[J].Pediatr Emerg Care,2007,23(11):816-819.DOI: 10.1097/PEC.0b013e31815a060b.
2 Oh CW,Park BC,Ihn JC,et al.Fracture separation of the distal humeral epiphysis in children younger than three years old[J].J Pediatr Orthop,2000,20(2):173-176.
3 Delee JC,Wilkins KE,Rogers LF,et al.Fracture-separation of the distal humeral epiphysiolysis[J].J Bone Joint Surg Am, 1980,62(1):46-51.
4 Flynn JC,Matthews JG,Benoit RL.Blind pinning of displaced supracondylar fractures of the humerus in children.Sixteen years’ experience with long-term follow-up[J].J Bone Joint Surg Am,1974,56(2):263-272.
5 Bell P,Scannell BP,Loeffler BJ,et al.Adolescent Distal Humerus Fractures: ORIF Versus CRPP[J].J Pediatr Orthop,2017,37(8):511-520.DOI:10.1097/BPO.0000000000000715.
6 王亦璁,孟继懋,郭子恒.骨与关节损伤[M].北京:人民卫生出版社,1996,124.Wang YJ,Meng JM,Guo ZH.Bone and Joint Injuries[M].Beijing: People’s Health Publishing House,1996,124.
7 Wilkins KE.Fractures and dislocationsof the elbow region[J].Fractures in Children,1984,373.
8 吴蔚,程富礼,宋相建,等.儿童肱骨远端全骨骺分离的临床特点及诊治要点[J].中国骨与关节损伤杂志,2009,24(2):136-137.Wu W,Cheng FL,Song XJ,et al.Clinical features and key points of diagnosis and treatment of distal humeral epiphyseal separation in children[J].Chinese Journal of Bone and Joint Injury,2009,24 (2): 136-137.
9 Chou ACC,Wong HYK,Kumar S,et al.Using the Medial and Lateral Humeral Lines as an Adjunct to Intraoperative Elbow Arthrography to Guide Intraoperative Reduction and Fixation of Distal Humerus Physeal Separations Reduces the Incidence of Postoperative Cubitus Varus[J].J Pediatr Orthop,2018,38(5):e262-e266.DOI:10.1097/BPO.0000000000001156.
10 刘雪涛,李忠,张成进,等.儿童肱骨远端全骺分离的手术治疗[J].中国矫形外科杂志,2007,15(14):1109-1111.DOI:10.3969/j.issn.1005-8478.2007.14.022.Liu XT,Li Z,Zhang CJ,et al.Operations of total distal humeral epiphysiolysis[J].Orthopedic Journal of China,2007,15(14):1109-1111.DOI:10.3969/j.issn.1005-8478.2007.14.022.
11 周海,李明.手术治疗儿童肱骨远端全骺分离197例临床疗效分析[J].重庆医科大学学报,2015,40(2):226-229.DOI:10.13406/j.cnki.cyxb.000122.Zhou H,Li M.Surgical efficacies for distal humeral epiphysiolysis fracture in children: a report of 197 cases[J].Journal of Chongqing Medical University,2015,40(2):226-229.DOI:10.13406/j.cnki.cyxb.000122.
Memo
收稿日期:2018-09-15。
基金项目:国家中医药管理局中医药标准化项目（编号：SATCM-2015-BZ（200））
通讯作者:周英,Email:344366562@qq.com