一项使用新鲜冷冻成人尸体的儿童内侧上髁骨折研究,比较骨折移位和肘关节末梢伸展的丧失

Jue Cao, Brandon S Smetana, P. Carry, Kathryn M. Peck, G. Merrell
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引用次数: 3

摘要

内侧上髁骨折是第三常见的儿童肘部骨折。无论采用何种治疗方法,都有一定程度的肘关节运动丧失的报道。我们研究的目的是确定成人尸体内上髁骨折模型中前侧骨折移位量与肘关节被动伸展丧失之间的关系。15具新鲜冷冻成人尸体分别在2、5、10 mm和最大位移情况下制作骨折模型。记录每个尸体模型在每种骨折情况下的终末肘关节伸展。采用线性混合模型回归分析来检验骨折位移与肘关节末梢被动伸展丧失之间的关系。位移2mm时,末端延伸的平均损失为3.89°;在5mm处,为7°;在10毫米处,为10.7°;最大位移(~15 mm)为17°。骨折移位与肘关节末梢伸直损失之间存在统计学上显著的线性正相关(5毫米移位=约4.7°的损失)。在我们的骨折模型中,当内侧上髁向前移位时,我们注意到内侧副韧带张力的变化,导致肘关节末梢伸展减少。然而,在临床文献中,这只是部分地导致了运动能力的丧失。尽管我们的研究结果不支持手术干预以防止内侧上髁骨折患者肘关节活动丧失的建议,但我们仍然鼓励医生考虑移位的后果及其对肘关节活动范围的潜在影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A pediatric medial epicondyle fracture study using fresh frozen adult cadavers comparing fracture displacement and loss of terminal elbow extension
Medial epicondyle fractures are the 3rd most common pediatric elbow fractures. Regardless of treatment method, some degree of elbow motion loss has been reported. The purpose of our study was to determine the relationship between the amount of anterior fracture displacement and loss of elbow passive extension in an adult cadaveric medial epicondyle fracture model. Fifteen fresh frozen adult cadavers were procured to create fracture models at scenarios of 2, 5, 10 mm, and maximum displacement. Terminal elbow extension was recorded for each cadaveric model at each fracture scenario. A linear mixed model regression analysis was used to test the association between fracture displacement and loss of terminal elbow passive extension. At 2 mm of displacement, the average loss of terminal extension was 3.89°; at 5 mm, it was 7°; at 10 mm, it was 10.7°; at maximum displacement (~15 mm), it was 17°. A statistically significant positive linear association between fracture displacement and loss of terminal elbow extension was observed (5 mm of displacement = loss of ~4.7°). In our fracture model, when the medial epicondyle displaced anteriorly, we noticed a change in the tension of the medial collateral ligaments which lead to a decrease in terminal elbow extension. However, this only contributed partially to the loss of motion observed clinically in the literature. Even though our findings did not support the recommendation of surgical intervention to prevent loss of elbow motion in medial epicondyle fractures, we still encourage physicians to consider the consequence of displacement and its potential influence of elbow range of motion.
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