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]
闭合复位经皮克氏针固定治疗儿童肱骨外髁骨折的疗效及并发症相关因素分析
- Title:
- 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
- 摘要:
- 目的 评价闭合复位经皮克氏针固定治疗儿童肱骨外髁骨折(lateral humeral condylar fracture,LHCF)的临床疗效及并发症相关因素。方法 回顾性分析鹰潭一八四医院骨科2020年3月至2023年6月行闭合复位经皮克氏针固定治疗的94例LHCF患儿临床资料。记录患儿手术时间、术中出血量、住院时间、身体质量指数 (body mass index,BMI)、骨折部位、受伤方式、骨密度、骨折初始移位情况、手术时机、术后开始功能锻炼时间等。随访6~12个月,进行疗效判定,并根据是否出现针道感染、肘内外翻、延迟愈合等并发症分为正常组(84例)和并发症组(10例)。采用单因素分析和多元Logistic回归模型分析术后发生并发症的相关因素。结果 采用闭合复位经皮克氏针固定治疗LHCF的手术时间为(56.62±8.95) min,术中出血量为(2.34±0.36) mL,住院时间为(4.93±1.15) d。疗效优52例、良33例、可6例、差3例,疗效优良率为90.43%(85/94)。随访期间出现钉道感染4例,肘内翻1例,肘外翻2例,延迟愈合1例,关节僵硬2例,并发症发生率为10.64%(10/94)。单因素分析显示,BMI、骨密度、骨折初始移位、手术时机和术后开始功能锻炼的时间与术后并发症的发生有关(P＜0.05)。多因素分析表明,骨密度、骨折初始移位、手术时机、术后开始功能锻炼的时间是术后并发症发生的独立影响因素(P＜0.05)。结论 闭合复位经皮克氏针固定治疗LHCF手术时间短,出血量少,住院时间短,疗效好,并发症较少。术后并发症的发生与患儿骨密度、骨折初始移位、手术时机、术后开始功能锻炼的时间有关。
- 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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备注/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