Minimally invasive surgical technique for unstable supracondylar humerus fractures in children (Gartland type III or IV)

Chang-Hyun Lee, Sung-Taek Jung, Chun-Gon Park, Joonyeong Kim, Gyo Rim Kang, Sungmin Kim
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Abstract

Achieving and maintaining anatomical reduction during the treatment of pediatric humerus fractures, classified as Gartland type III or IV, presents a clinical challenge. Herein, we present a minimally invasive surgical approach using a novel and simple K-wire push technique that aids in achieving and maintaining anatomical reduction.We reviewed data of children receiving treatment for supracondylar fractures of the humerus at our hospital between January 2016 and December 2020. Patients were divided into two groups based on the method of treatment: Group 1 was treated with the K-wire push technique, and Group 2 was treated with the standard technique as described by Rockwood and Wilkins. The medical records and radiographic images were reviewed. In total, 91 patients with Gartland types III and IV fractures were included, with 37 and 54 patients in Groups 1 and 2, respectively.The postoperative reduction radiographic parameters and Flynn scores at final follow-up were not significantly different between the two groups.The minimally invasive K-wire push technique for unstable supracondylar fractures in children is a safe and effective alternative for improving reduction. Using this technique, complications can be minimized, and the requirement for open reduction can be reduced.
儿童不稳定肱骨髁上骨折(Gartland III 型或 IV 型)的微创手术技术
在治疗小儿肱骨骨折(Gartland III型或IV型)的过程中,实现并保持解剖复位是一项临床挑战。我们回顾了 2016 年 1 月至 2020 年 12 月期间在我院接受治疗的肱骨髁上骨折患儿的数据。根据治疗方法将患者分为两组:第1组采用K线推动技术治疗,第2组采用Rockwood和Wilkins描述的标准技术治疗。对病历和放射影像进行了审查。两组患者的术后复位影像学参数和最终随访时的 Flynn 评分无显著差异。微创 K 线推动技术治疗儿童不稳定肱骨髁上骨折是改善复位的一种安全有效的替代方法。使用该技术可最大限度地减少并发症,并降低开放复位的要求。
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