WenTao Wang, QianQian Mei, Hang Liu, YueMing Guo, HaiBo Mei, Federico Canavese, Antonio Andreacchio, HanQing Lyu, ShunYou Chen, ShengHua He
{"title":"142例未经治疗的慢性蒙氏骨折患儿桡骨近端异常的危险因素","authors":"WenTao Wang, QianQian Mei, Hang Liu, YueMing Guo, HaiBo Mei, Federico Canavese, Antonio Andreacchio, HanQing Lyu, ShunYou Chen, ShengHua He","doi":"10.1186/s10195-024-00793-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The risk factors for proximal radial abnormalities (PRA) in paediatric patients with untreated chronic Monteggia fractures (CMFs) are unclear. This multicentre study aimed to evaluate the risk factors for PRA in children with untreated CMFs.</p><p><strong>Materials and methods: </strong>The clinical data of 142 patients (mean age at the time of injury: 5.73 years) with untreated unilateral CMFs were retrospectively reviewed. The radial neck-shaft angle (RNS<sub>AP</sub>) and radial head size (RH<sub>L</sub>) were measured on anteroposterior (AP) and lateral (L) radiographs, respectively. The RH<sub>L</sub> size was the ratio of the widest width of the proximal radial metaphysis to the narrowest radial neck width. The En-RNS<sub>AP</sub> and En-RH<sub>L</sub> were the ratios of the enlargement (En) of the RNS<sub>AP</sub> angle and RH<sub>L</sub> size of the injured elbow to those of the uninjured elbow, respectively. Paired-sample t-tests, single-factor analyses and multiple linear regression analyses were performed to evaluate the correlation between the differences in these parameters between the injured and uninjured elbows and the assessed risk factors. These risk factors included institution, sex, laterality, age at injury, time from injury to diagnosis, direction of RH dislocation, distance of RH dislocation (DD-RH), presence of radial or median nerve injury, heterotopic ossification and immobilization of the elbow after injury.</p><p><strong>Results: </strong>In children with untreated CMFs (mean time from injury to diagnosis: 14.6 months), Student's t-test revealed a significant difference in the RH<sub>L</sub> size (P < 0.001) but not in the RNS<sub>AP</sub> angle (P = 0.075) between the injured and uninjured elbows. Pearson correlation analysis revealed a potential correlation between En-RH<sub>L</sub> and age at the time of injury (P = 0.069), time from injury to diagnosis (P < 0.001) and DD-RH (P < 0.001), excluding other risk factors (P > 0.05). Multiple linear regression analysis revealed that age at the time of injury (P = 0.047), time from injury to diagnosis (P = 0.007) and DD-RH (P = 0.001) were risk factors for an increased En-RH<sub>L</sub> in patients with untreated CMFs; the variability in En-RH<sub>L</sub> among the other three risk factors was 21.4%.</p><p><strong>Conclusions: </strong>In paediatric patients with unilateral untreated CMFs, PRA of the injured elbow consisted mainly of RH enlargement or radial neck narrowing rather than valgus deformities of the proximal radius. Older age at injury, increased time from injury to diagnosis and DD-RH were risk factors for more severe PRA.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":"25 1","pages":"60"},"PeriodicalIF":3.0000,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607283/pdf/","citationCount":"0","resultStr":"{\"title\":\"Risk factors for proximal radial abnormalities in children with untreated chronic Monteggia fractures: a review of 142 cases.\",\"authors\":\"WenTao Wang, QianQian Mei, Hang Liu, YueMing Guo, HaiBo Mei, Federico Canavese, Antonio Andreacchio, HanQing Lyu, ShunYou Chen, ShengHua He\",\"doi\":\"10.1186/s10195-024-00793-z\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The risk factors for proximal radial abnormalities (PRA) in paediatric patients with untreated chronic Monteggia fractures (CMFs) are unclear. This multicentre study aimed to evaluate the risk factors for PRA in children with untreated CMFs.</p><p><strong>Materials and methods: </strong>The clinical data of 142 patients (mean age at the time of injury: 5.73 years) with untreated unilateral CMFs were retrospectively reviewed. The radial neck-shaft angle (RNS<sub>AP</sub>) and radial head size (RH<sub>L</sub>) were measured on anteroposterior (AP) and lateral (L) radiographs, respectively. The RH<sub>L</sub> size was the ratio of the widest width of the proximal radial metaphysis to the narrowest radial neck width. The En-RNS<sub>AP</sub> and En-RH<sub>L</sub> were the ratios of the enlargement (En) of the RNS<sub>AP</sub> angle and RH<sub>L</sub> size of the injured elbow to those of the uninjured elbow, respectively. Paired-sample t-tests, single-factor analyses and multiple linear regression analyses were performed to evaluate the correlation between the differences in these parameters between the injured and uninjured elbows and the assessed risk factors. These risk factors included institution, sex, laterality, age at injury, time from injury to diagnosis, direction of RH dislocation, distance of RH dislocation (DD-RH), presence of radial or median nerve injury, heterotopic ossification and immobilization of the elbow after injury.</p><p><strong>Results: </strong>In children with untreated CMFs (mean time from injury to diagnosis: 14.6 months), Student's t-test revealed a significant difference in the RH<sub>L</sub> size (P < 0.001) but not in the RNS<sub>AP</sub> angle (P = 0.075) between the injured and uninjured elbows. Pearson correlation analysis revealed a potential correlation between En-RH<sub>L</sub> and age at the time of injury (P = 0.069), time from injury to diagnosis (P < 0.001) and DD-RH (P < 0.001), excluding other risk factors (P > 0.05). Multiple linear regression analysis revealed that age at the time of injury (P = 0.047), time from injury to diagnosis (P = 0.007) and DD-RH (P = 0.001) were risk factors for an increased En-RH<sub>L</sub> in patients with untreated CMFs; the variability in En-RH<sub>L</sub> among the other three risk factors was 21.4%.</p><p><strong>Conclusions: </strong>In paediatric patients with unilateral untreated CMFs, PRA of the injured elbow consisted mainly of RH enlargement or radial neck narrowing rather than valgus deformities of the proximal radius. Older age at injury, increased time from injury to diagnosis and DD-RH were risk factors for more severe PRA.</p><p><strong>Level of evidence: </strong>III.</p>\",\"PeriodicalId\":48603,\"journal\":{\"name\":\"Journal of Orthopaedics and Traumatology\",\"volume\":\"25 1\",\"pages\":\"60\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2024-11-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607283/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Orthopaedics and Traumatology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s10195-024-00793-z\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Orthopaedics and Traumatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s10195-024-00793-z","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Risk factors for proximal radial abnormalities in children with untreated chronic Monteggia fractures: a review of 142 cases.
Background: The risk factors for proximal radial abnormalities (PRA) in paediatric patients with untreated chronic Monteggia fractures (CMFs) are unclear. This multicentre study aimed to evaluate the risk factors for PRA in children with untreated CMFs.
Materials and methods: The clinical data of 142 patients (mean age at the time of injury: 5.73 years) with untreated unilateral CMFs were retrospectively reviewed. The radial neck-shaft angle (RNSAP) and radial head size (RHL) were measured on anteroposterior (AP) and lateral (L) radiographs, respectively. The RHL size was the ratio of the widest width of the proximal radial metaphysis to the narrowest radial neck width. The En-RNSAP and En-RHL were the ratios of the enlargement (En) of the RNSAP angle and RHL size of the injured elbow to those of the uninjured elbow, respectively. Paired-sample t-tests, single-factor analyses and multiple linear regression analyses were performed to evaluate the correlation between the differences in these parameters between the injured and uninjured elbows and the assessed risk factors. These risk factors included institution, sex, laterality, age at injury, time from injury to diagnosis, direction of RH dislocation, distance of RH dislocation (DD-RH), presence of radial or median nerve injury, heterotopic ossification and immobilization of the elbow after injury.
Results: In children with untreated CMFs (mean time from injury to diagnosis: 14.6 months), Student's t-test revealed a significant difference in the RHL size (P < 0.001) but not in the RNSAP angle (P = 0.075) between the injured and uninjured elbows. Pearson correlation analysis revealed a potential correlation between En-RHL and age at the time of injury (P = 0.069), time from injury to diagnosis (P < 0.001) and DD-RH (P < 0.001), excluding other risk factors (P > 0.05). Multiple linear regression analysis revealed that age at the time of injury (P = 0.047), time from injury to diagnosis (P = 0.007) and DD-RH (P = 0.001) were risk factors for an increased En-RHL in patients with untreated CMFs; the variability in En-RHL among the other three risk factors was 21.4%.
Conclusions: In paediatric patients with unilateral untreated CMFs, PRA of the injured elbow consisted mainly of RH enlargement or radial neck narrowing rather than valgus deformities of the proximal radius. Older age at injury, increased time from injury to diagnosis and DD-RH were risk factors for more severe PRA.
期刊介绍：
The Journal of Orthopaedics and Traumatology, the official open access peer-reviewed journal of the Italian Society of Orthopaedics and Traumatology, publishes original papers reporting basic or clinical research in the field of orthopaedic and traumatologic surgery, as well as systematic reviews, brief communications, case reports and letters to the Editor. Narrative instructional reviews and commentaries to original articles may be commissioned by Editors from eminent colleagues. The Journal of Orthopaedics and Traumatology aims to be an international forum for the communication and exchange of ideas concerning the various aspects of orthopaedics and musculoskeletal trauma.
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