Shi Jianing,Zhang Lin,Zhou Xianjun,et al.A comparative study of anterograde elastic intramedullary needling versus Kirschmann wiring for radial trunk and metaphyseal junction fractures in children[J].Journal of Clinical Pediatric Surgery,,22():866-870.[doi:10.3760/cma.j.cn101785-202207058-013]
A comparative study of anterograde elastic intramedullary needling versus Kirschmann wiring for radial trunk and metaphyseal junction fractures in children
- Keywords:
- Fracture Fixation; Intramedullary; Radius Fractures; Surgical Procedures; Operative; Child
- Abstract:
- Objective To compare the clinical efficacy and application value of a novel operative approach of anterograde elastic intramedullary needling versus traditional Kirschmann wiring for junction fractures of radius trunk and metaphyseal in children.Methods Retrospective analysis was performed for 50 children with fractures at junction of distal radial diaphysis and metaphysis from January 2019 to January 2022.They were assigned into two groups of anterograde elastic intramedullary acupuncture (n=17) and Kirschmann acupuncture (n=33) according to different surgical approaches.The relevant clinical data included gender,age,concurrent distal ulnar fracture,operative duration,fracture angulation and alignment status at Week 2 post-operation.Duration of external fixation,wrist motion,good/excellent rate of wrist function,good/excellent rate of elbow function and complications were recorded at Month 3 post-operation.Results Operative duration was longer in anterograde elastic intramedullary acupuncture group than that in Kirschner’s needle group[(81.8±38.4) vs.(59.4±26.1) min]and the difference was not statistically significant (P>0.05).The mean contraction of fractures was higher in anterograde elastic intramedullary acupuncture anterograde elastic intramedullary acupuncture group than that in anterograde elastic intramedullary acupuncture Kirschner’s needle group (92% vs.88%) and the difference was not statistically significant (P>0.05).The removal time of external plaster fixation was shorter in anterograde elastic intramedullary acupuncture anterograde elastic intramedullary acupuncture anterograde elastic intramedullary acupuncture group than that in anterograde elastic intramedullary acupuncture anterograde elastic intramedullary acupuncture Kirschner’s needle group[(31.5±5.1) vs.(39.0±9.2) day]and the difference was statistically significant (P<0.05).The wrist range of motion was higher in anterograde elastic intramedullary acupuncture anterograde elastic intramedullary acupuncture group than that in anterograde elastic intramedullary acupuncture Kirschner’s needle anterograde elastic intramedullary acupuncture groupt Month 3 post-operation and the difference was statistically significant (P<0.05).The recovery rate of wrist joint was higher in anterograde elastic intramedullary acupuncture anterograde elastic intramedullary acupuncture group than that in anterograde elastic intramedullary acupuncture Kirschner’s needle group (94.12% vs.66.67%) and the difference was statistically significant (P<0.05).The good/excellent recovery rate of elbow joint was lower in anterograde elastic intramedullary acupuncture anterograde elastic intramedullary acupuncture group than that in anterograde elastic intramedullary acupuncture Kirschner’s needle group (82.35% vs.87.88%) and the difference was not statistically significant (P>0.05).Conclusion Compared with traditional Kirscher wiring,anterograde elastic intramedullary needling can effectively shorten the time of postoperative removal of plaster external fixation and facilitate the postoperative recovery of wrist joint activity.It is ideal for children with distal radial diaphyseal junction fractures and worth wider clinical promotions.
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Memo
收稿日期:2022-7-30。
通讯作者:李富江,Email:lifujiang_88@163.com