SUPRACONDYLAR FRACTURES IN CHILDREN: A SYSTEMATIC REVIEW OF TREATMENT OPTIONS.

IF 0.5 4区 医学 Q4 ORTHOPEDICS
Acta Ortopedica Brasileira Pub Date : 2024-08-02 eCollection Date: 2024-01-01 DOI:10.1590/1413-785220243203e278420
Douglas Hideo Higuchi, Gabriel Alencar de Oliveira, João Paulo Alves, Lucas Lebedenco, Eiffel Tsuyoshi Dobashi
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引用次数: 0

Abstract

Objective: To compare the outcomes of surgical stabilization of pediatric supracondylar humeral fractures with the use of crossed Kirschner wires versus divergent lateral pinning wires.

Methods: This is a systematic review with meta-analysis carried out by searching the MEDLINE/PubMed, Science Direct and Scielo databases. In these, the search for journals was carried out between January and August 2023, where 695 studies were found. To assess the quality of the studies, the Jadad and the MINORS scales were used.. The selection and reading of relevant articles were carried out by the researchers and 11 studies met the selection criteria.

Results: From the 11 selected studies, 963 patients who met the criteria for the surgical treatment of these fractures were grouped. After the statistical analysis, we found that the ulnar nerve injury had a higher incidence when the crossed-K wire technique was used; and the lateral fixation is safer for the ulnar nerve.

Conclusion: Both fixation techniques determine good functional results. However, fixation with lateral Kirschner wires proves to be safer considering the risk of iatrogenic injury to the ulnar nerve. Crossed-K wire fixation is more effective in terms of stability and maintenance of fracture reduction. Level of Evidence II, Systematic Review of Level II or Level I Studies with discrepant results.

儿童髁上骨折:治疗方案的系统回顾。
目的比较小儿肱骨髁上骨折手术稳定中使用交叉Kirschner钢丝与发散侧向固定钢丝的效果:这是一篇系统性综述,通过检索 MEDLINE/PubMed、Science Direct 和 Scielo 数据库进行荟萃分析。在这些数据库中,对 2023 年 1 月至 8 月期间的期刊进行了检索,共找到 695 项研究。评估研究质量时使用了 Jadad 和 MINORS 量表。研究人员对相关文章进行了筛选和阅读,有 11 项研究符合筛选标准:从所选的 11 项研究中,我们对符合标准的 963 例此类骨折手术治疗患者进行了分组。经过统计分析,我们发现使用交叉K线技术时尺神经损伤的发生率更高;而侧向固定对尺神经更安全:结论:两种固定技术都能获得良好的功能效果。结论:两种固定技术都能获得良好的功能效果,但考虑到尺神经先天性损伤的风险,使用外侧 Kirschner 钢丝固定更安全。交叉K线固定在稳定性和维持骨折复位方面更为有效。证据等级 II,对结果不一致的 II 级或 I 级研究进行系统回顾。
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来源期刊
CiteScore
0.90
自引率
14.30%
发文量
67
审稿时长
25 weeks
期刊介绍: A Revista Acta Ortopédica Brasileira, órgão oficial do Departamento de Ortopedia e Traumatologia da Faculdade de Medicina da Universidade de São Paulo (DOT/FMUSP), é publicada bimestralmente em seis edições ao ano (jan/fev, mar/abr, maio/jun, jul/ago, set/out e nov/dez) com versão em inglês disponível nos principais indexadores nacionais e internacionais e instituições de ensino do Brasil. Sendo hoje reconhecidamente uma importante contribuição para os especialistas da área com sua seriedade e árduo trabalho para as indexações já conquistadas.
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