Ahmet Hamdi Akgülle, Yavuz Şahbat, Özgür Baysal, Hayati Kart, Bülent Erol
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引用次数: 4
Abstract
Background: Supracondylar humerus fractures (SCHF) are rarely seen in the youngest age groups (1-3 years). Although there is no difference in the context of treatment options, it has been shown that younger age groups have different characteristics. Few studies have examined toddlers, which have notably different characteristics. This study is the first to report the characteristics, diagnosis, treatment and functional results of SCHF in infants and early toddlers.
Methods: A retrospective analysis was made of the data of patients younger than 30 months old, who were operated on in our clinic for SCHF between 2012 and 2020 with at least 2 years of follow-up. Patient demographic and surgical data, and the functional and radiological results were documented.
Results: Evaluation was made of a total of 52 patients comprising 30 females (58%) and 22 males (42%), with a mean age of 20.75 ± 5.4 months (range, 6-30 months). The injury was in the right elbow in 24 (46%) patients. The mechanism of injury was a fall from an object at home (table, chair, bed, etc.) in 41 (79%) patients. Patients who fell from a height of more than 4 meters had additional injuries (liver laceration, vertebral fracture, etc.). Only 1 patient had anterior interosseous nerve (AIN) damage before the operation, but the final follow-up neurovascular examinations for all patients were normal. The median follow-up period was 4 years (range, 2-7 years). Flynn outcome scores were (88.5%) excellent and variant Hospital for Special Surgery scores were (82.7%) excellent.
Conclusions: With appropriate treatment of SCHF, the clinical outcomes in infants and early toddlers are excellent. Using a medial pin to achieve and protect stability in this age group does not increase the risk of iatrogenic ulnar nerve damage. Patients younger than 20 months tend to have more varus malalignment but similar functional results.
背景:肱骨髁上骨折(SCHF)很少见于年龄最小的年龄组(1-3岁)。虽然在治疗选择的背景下没有差异，但已经表明，较年轻的年龄组具有不同的特征。很少有研究对幼儿进行调查，因为他们有明显不同的特征。本研究首次报道了婴幼儿SCHF的特征、诊断、治疗和功能结果。方法:回顾性分析2012年至2020年在我诊所手术的年龄小于30个月的SCHF患者的资料，随访时间至少2年。记录了患者的人口统计和手术数据，以及功能和放射学结果。结果:共纳入52例患者，其中女性30例(58%)，男性22例(42%)，平均年龄20.75±5.4个月(范围6-30个月)。24例(46%)患者发生右肘损伤。41例(79%)患者的损伤机制为从家中物体(桌子、椅子、床等)上摔下。从4米以上高处坠落的患者有附加损伤(肝裂伤、椎体骨折等)。只有1例患者术前有前骨间神经损伤，但所有患者最终随访神经血管检查均正常。中位随访期为4年(范围2-7年)。Flynn评分为优(88.5%)，variant Hospital for Special Surgery评分为优(82.7%)。结论:患儿经适当治疗，临床疗效良好。在这个年龄组使用内侧针来实现和保护稳定性不会增加医源性尺神经损伤的风险。年龄小于20个月的患者往往有更多的内翻错位，但功能结果相似。
期刊介绍：
Journal of Investigative Surgery publishes peer-reviewed scientific articles for the advancement of surgery, to the ultimate benefit of patient care and rehabilitation. It is the only journal that encompasses the individual and collaborative efforts of scientists in human and veterinary medicine, dentistry, basic and applied sciences, engineering, and law and ethics. The journal is dedicated to the publication of outstanding articles of interest to the surgical research community.
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