Comparison of two modalities of Kirschner pin fixation for severely displaced (Campbell type Ⅱ) juxta-epiphyseal fracture of the proximal phalanx in children
10.3760/cma.j.cn115530-20240611-00247
- VernacularTitle:两种不同克氏针固定方式治疗儿童Campbell Ⅱ型近节指骨骺旁骨折的疗效比较
- Author:
Shuaiyin WANG
1
;
Zilong HUANG
;
Jiahui LI
;
Guibing FU
Author Information
1. 深圳市儿童医院骨科，深圳 518000
- Keywords:
Child;
Finger phalanges;
Fracture fixation, internal;
Kirschner pin;
Juxtaepiphyseal fracture
- From:
Chinese Journal of Orthopaedic Trauma
2024;26(11):972-977
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare 2 modalities of Kirschner pin fixation for severely displaced (Campbell type Ⅱ) juxta-epiphyseal fracture of the proximal phalanx in children.Methods:A retrospective study was conducted to analyze the clinical data of 69 children with severely displaced (Campbell type Ⅱ) juxta-epiphyseal fracture of the proximal phalanx who had been treated at Department of Orthopaedics, Shenzhen Children's Hospital from January 2018 to December 2020. Clinical data: 41 boys and 28 girls; (7.6±3.2) years in age; 34 left hands and 35 right hands affected; 4 thumbs, 4 middle fingers, 5 ring fingers, and 56 little fingers injured. The patients were divided into 2 groups according to surgical modalities. Group A (35 fingers in 35 cases) was treated by closed reduction, longitudinal intramedullary fixation with a single Kirschner pin, and external plaster fixation while group B (34 fingers in 34 cases) by closed reduction, crossing fixation with 2 Kirschner pins, and external plaster fixation. The 2 groups were compared in terms of preoperative fracture angulation, operation time, postoperative fracture angulation, hospitalization days, and postoperative functional recovery.Results:There was no statistically significant difference in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). All fractures got united after 3 to 6 weeks. There was no statistically significant difference between the 2 groups in terms of preoperative fracture angulation, operation time, or postoperative fracture angulation ( P>0.05). The hospitalization days in group A were significantly shorter than that in group B ( P<0.05). Fifty children (24 cases in group A and 26 cases in group B) were followed up for (54.3±10.5) months. By the trial criteria for upper limb functional evaluation of the Hand Surgery Society, the hand function was evaluated at the last follow-up as excellent in 24 cases in group A, giving an excellent rate of 100% (24/24), and as excellent in 26 cases in group B, giving an excellent rate of 100% (26/26) too, showing no significant difference between the 2 groups ( P<0.05). No postoperative complications such as Kirschner wire breakage, needle tract infection, significant angular deformity, rotational deformity, or bone bridge formation occurred in any of the patients. Conclusion:For children with severely displaced (Campbell type Ⅱ) juxta-epiphyseal fracture of the proximal phalanx, longitudinal intramedullary fixation with a single Kirschner pin and crossing fixation with 2 Kirschner pins may achieve comparable efficacy in terms of fracture stability and function, but the former may result in shorter hospitalization days.
