Wu Yu,Chen Wenhao.Clinical outcomes of early versus delayed treatment for fresh lateral humeral condyle fracture in children[J].Journal of Clinical Pediatric Surgery,2026,(09):863-866.[doi:10.3760/cma.j.cn101785-20260304-00086]
儿童新鲜肱骨外髁骨折早期与延迟治疗的临床疗效研究
- Title:
- Clinical outcomes of early versus delayed treatment for fresh lateral humeral condyle fracture in children
- Keywords:
- Lateral Humeral Condyle Fracture; Surgical Therapy; Early Treatment; Delay; Delayed Treatment; Clinical Outcome
- 摘要:
- 目的 比较早期手术与延迟手术治疗儿童新鲜肱骨外髁骨折的临床效果。方法 回顾性分析2020年1月至2023年12月浙江大学医学院附属儿童医院收治的169例新鲜肱骨外髁骨折患儿临床资料。受伤至手术时间＜1周为早期治疗组（138例），≥1周且＜3周为延迟治疗组（31例）。观察指标包括手术时间、克氏针数量、手术方式、术中出血量、术后Mayo肘关节功能评分、影像学指标（肱骨髁宽度、肱骨角、尺骨角、提携角）以及术后并发症。结果 早期治疗组和延迟治疗组患儿日常活动项[25(25，25)分比25(25，25)分]、肱骨角[76.00(72.50，81.00)°比67.50(66.00，70.00)°]比较，差异具有统计学意义（P＜0.05）；早期治疗组中切开复位比闭合复位手术方式在疼痛项、稳定性项及Mayo总评分上的差异均有统计学意义（P＜0.05），其余观察指标差异均无统计学意义（P>0.05）。结论 早期治疗在日常活动恢复、肱骨角预后方面更具优势；早期治疗中闭合复位在疼痛控制、肘关节稳定性及总体功能评分上优于切开复位。
- Abstract:
- Objective To compare the clinical outcomes between early surgery and delayed surgery for fresh lateral humeral condyle fracture in children.Methods A retrospective analysis was performed for the relevant clinical data of 169 children hospitalized with fresh lateral humeral condyle fractures at Children’s Hospital,Zhejiang University School of Medicine from January 2020 to December 2023.According to the interval between injury and surgery,they were assigned into two groups of early treatment (<1 week,n=138) and delayed treatment (≥1 week and <3 weeks,n=31).Observation parameters included operative duration,count of Kirschner wire,surgical approach,intraoperative volume of blood loss,postoperative Mayo elbow performance score,radiographic parameters (humeral condylar width,Baumann angle,ulnar angle & carrying angle) and postoperative complications.Results Statistically significant inter-group differences existed in activities of daily living score [25(25,25) vs. 25(25,25)] and Baumann angle [76.00(72.50,81.00)° vs. 67.50(66.00,70.00)°] (P<0.05).In early treatment group,as compared with open reduction,closed reduction showed statistically significant differences in pain score (P<0.001),stability score (P=0.040) and total Mayo score (P<0.001) (P<0.05).No statistically significant differences existed in other parameters (P>0.05).Conclusion Early treatment offers greater advantages in recovery of daily activities and prognosis of Baumann angle.In early treatment group,closed reduction is superior to open reduction in pain control,elbow joint stability and overall functional outcomes.
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备注/Memo
收稿日期:2026-3-4。
通讯作者:陈文昊,Email:whchenortho@zju.edu.cn