Comparison of percutaneous Kirschner wiring and elastic intramedullary nailing for radial neck fractures in children
10.3760/cma.j.cn115530-20240409-00157
- VernacularTitle:经皮克氏针固定与弹性髓内钉内固定治疗儿童桡骨颈骨折的疗效比较
- Author:
Hailong MA
1
;
Xiwei SUN
;
Fang LIU
;
Zhongtuo HUA
;
Yi YUAN
;
Sicheng ZHANG
Author Information
1. 安徽省儿童医院，安徽医科大学儿童医学中心骨科，合肥 230051
- Keywords:
Child;
Ultrasonography;
Fracture fixation, internal;
Radial neck fractures;
Kirschner wiring;
Elastic intramedullary nailing
- From:
Chinese Journal of Orthopaedic Trauma
2024;26(8):691-697
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare percutaneous Kirschner wiring and elastic intramedullary nailing after ultrasound-guided reduction in the treatment of radial neck fractures in children.Methods:A retrospective study was conducted to analyze the 96 children with radial neck fracture who had been admitted to Department of Orthopedics, Children's Hospital of Anhui Province from January 2020 to January 2023. They were 51 boys and 45 girls with an age of (7.0±2.5) years. By the Judet classification, there were 74 cases of type Ⅲ and 22 cases of type IV. Twenty-one cases were treated with percutaneous Kirschner wiring after ultrasound-guided reduction (Kirschner wire group) while 75 cases with elastic intramedullary nailing after ultrasound-guided reduction (intramedullary nail group). The surgical time, fluoroscopy frequency, fracture healing time, and incidence of complications were compared between the 2 groups. Their postoperative X-ray films were evaluated according to the Métaizeau criteria, and elbow joint function was evaluated according to the Steel and Gtrham scoring at the last follow-up.Results:There was no statistically significant difference in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). The 96 pediatric patients were followed up for (10.6±4.2) months after surgery. The surgical time [(18.5±2.6) minutes] and fluoroscopy frequency [4.0 (3.0, 4.0) times] in the Kirschner wire group were significantly less than those in the intramedullary nail group [(30.9±2.7) minutes, 8.0 (7.0, 9.0) times] ( P<0.05). There was no statistically significant difference in fracture healing time, good and excellent rate of postoperative reduction by the Métaizeau criteria, good and excellent rate of elbow joint function by the Steel and Gtrham scoring at the last follow-up, or incidence of complications ( P>0.05). Conclusion:In the treatment of radial neck fractures in children, both ultrasound-guided percutaneous Kirschner wiring and elastic intramedullary nailing after ultrasound-guided reduction can lead to similar therapeutic effects, but the former can shorten surgical time, reduce intraoperative fluoroscopy frequency, and spare a secondary surgery.
