Preoperative “target marking” on the skin reduces radiation exposure and total surgical duration in surgically treated pediatric supracondylar humerus fractures: a case-control clinical study
Yasin Erdoğan MD , Şahan Güven MD , Fırat Yaman MD , Ali Said Nazlıgül MD , Ali Şahin MD , Christos Koutserimpas MD , Enejd Veizi MD
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Abstract
Background
Primary treatment for supracondylar humerus fractures (SCHF) involves a closed reduction and fixation with K-wires. The aim of this study is to investigate whether a target marking of the humerus is effective in reducing operation duration and radiation exposure in surgically treated pediatric SCHF.
Methods
Patients treated with a closed reduction and percutaneous pinning for an SCHF between 2019 and 2023 were included. The study data were categorized into 2 groups: group 1 patients underwent closed reduction, followed by outlining the boundaries of the humerus on the skin and subsequent fixation with K-wires (target marking group), whereas group 2 patients underwent closed reduction without outlining (unmarked group). The same K-wire configuration, consisting of 2 lateral and 1 medial crossed pinning, was used. Operation duration and the radiation dose received (in millisieverts) were recorded for each patient and then compared among them.
Results
Overall surgical duration was significantly shorter in group 1 (P < .001). A significantly lower radiation dose was required in patients of group 1 to achieve a satisfactory reduction for both fracture types and for the overall patient cohort (P < .001).
Conclusions
Enhancing the 3-dimensional perception of the surgeon in pediatric SCHF treated with closed reduction and percutaneous pinning resulted in a reduction of both the operative duration and the radiation dose. A novel method of “target marking” showed a significant reduction in surgical duration and the amount of radiation exposure.
期刊介绍：
The official publication for eight leading specialty organizations, this authoritative journal is the only publication to focus exclusively on medical, surgical, and physical techniques for treating injury/disease of the upper extremity, including the shoulder girdle, arm, and elbow. Clinically oriented and peer-reviewed, the Journal provides an international forum for the exchange of information on new techniques, instruments, and materials. Journal of Shoulder and Elbow Surgery features vivid photos, professional illustrations, and explicit diagrams that demonstrate surgical approaches and depict implant devices. Topics covered include fractures, dislocations, diseases and injuries of the rotator cuff, imaging techniques, arthritis, arthroscopy, arthroplasty, and rehabilitation.
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