Xiong Fei,Yang Yifei,Du Xiangping.Risk factors associated with residual rotational deformity after surgical treatment of Gartland type Ⅲ supracondylar humeral fractures in children[J].Journal of Clinical Pediatric Surgery,2026,(08):765-769.[doi:10.3760/cma.j.cn101785-202506055]
儿童Gartland Ⅲ型肱骨髁上骨折手术后残留旋转畸形的相关因素分析
- Title:
- Risk factors associated with residual rotational deformity after surgical treatment of Gartland type Ⅲ supracondylar humeral fractures in children
- 关键词:
- 肱骨髁上骨折; Gartland分型; 残留旋转畸形; 影响因素; 儿童
- Keywords:
- Supracondylar Humeral Fracture; Gartland Classification; Residual Rotational Deformity; Risk Factors; Child
- 摘要:
- 目的 探讨儿童Gartland Ⅲ型肱骨髁上骨折手术后残留旋转畸形的相关因素。方法 本研究为病例对照研究。收集江西省儿童医院骨科2019年1月至2024年7月收治的149例儿童Gartland Ⅲ型肱骨髁上骨折患儿临床资料，根据术后是否发生残留旋转畸形分为发生组（n=25）和未发生组(n=124)，分析两组年龄、性别、既往肘部手术史、合并内侧柱塌陷、受伤原因、骨折部位、受伤至手术时长、复位方式、合并血管/神经损伤、骨折移位方向、术前骨折端旋转角度、手术时长、克氏针布局等情况。采用多因素Logistic回归分析术后残留旋转畸形的影响因素。结果 单因素分析显示，发生组年龄大于未发生组[(7.88±2.86)岁比（5.42±2.11）岁]；发生组中合并内侧柱塌陷(40.00%比20.16%)、合并血管/神经损伤（72.00%比16.94%）、术前骨折端旋转角度≥15°（40.00%比18.55%）及克氏针布局为全外侧针（80.00%比58.87%）占比均高于未发生组，差异均具有统计学意义（P＜ 0.05）。多因素Logistic回归分析显示，年龄（OR=1.688，95%CI1.288~2.211）、合并内侧柱塌陷（OR=4.448，95%CI1.381~14.328）、合并血管/神经损伤（OR=3.341，95%CI1.052~10.608）、术前骨折端旋转角度≥ 15°（OR=3.797，95%CI1.165~12.374）、克氏针布局为全外侧针（OR=4.478，95%CI1.217~16.474）是术后残留旋转畸形的独立危险因素（P＜0.05）。结论 年龄大、合并内侧柱塌陷、合并血管/神经损伤、术前骨折端旋转角度≥15°、克氏针布局为全外侧针可能导致儿童Gartland Ⅲ型肱骨髁上骨折术后残留旋转畸形。
- Abstract:
- Objective To investigate the factors associated with residual rotational deformity after surgical treatment of Gartland type Ⅲ supracondylar humeral fractures in children. Methods This retrospective case-control study included 149 children with Gartland type Ⅲ supracondylar humeral fractures treated at the Department of Orthopedics,Jiangxi Provincial Children’s Hospital,between January 2019 and July 2024.Patients were divided into a residual rotational deformity group and a non-deformity group according to the presence or absence of postoperative residual rotational deformity.Clinical variables,including age,sex,previous elbow surgery history,concomitant medial column collapse,injury mechanism,fracture location,time from injury to surgery,reduction method,associated vascular/nerve injury,fracture displacement direction,preoperative fracture fragment rotation angle,operative time,and Kirschner wire configuration,were analyzed.Multivariable logistic regression analysis was performed to identify independent risk factors for postoperative residual rotational deformity. Results Among the 149 children,25 (16.78%) developed postoperative residual rotational deformity.Univariate analysis showed that patients in the residual deformity group were older than those in the non-deformity group.The proportions of concomitant medial column collapse,associated vascular or neural injury,preoperative fracture fragment rotation angle ≥15°,and all-lateral Kirschner wire configuration were significantly higher in the residual deformity group than in the non-deformity group (all P<0.05).Multivariable logistic regression analysis demonstrated that age (OR=1.688,95%CI1.288-2.211),concomitant medial column collapse (OR=4.448,95%CI1.381-14.328),associated vascular/nerve injury (OR=3.341,95%CI1.052-10.608),preoperative fracture fragment rotation angle (OR=3.797,95%CI1.165-12.374),and all-lateral Kirschner wire configuration (OR=4.478,95%CI1.217-16.474) were independent risk factors for postoperative residual rotational deformity (all P<0.05). Conclusion Older age,concomitant medial column collapse,associated vascular/nerve injury,preoperative fracture fragment rotation angle ≥15°,and all-lateral Kirschner wire configuration are independent risk factors for residual rotational deformity after surgical treatment of Gartland type Ⅲ supracondylar humeral fractures in children.
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备注/Memo
收稿日期:2026-5-17。
基金项目:江西省中医药管理局科技计划(2022B148)
通讯作者:熊飞,Email:xfjxsetyy@163.com