超声和关节造影辅助下治疗儿童肱骨远端骨骺分离的临床疗效分析

目的:比较超声与关节造影辅助下闭合复位经皮内固定术治疗儿童肱骨远端骨骺分离的临床疗效。方法:收集2013年4月至2017年8月收治于华中科技大学同济医学院附属武汉儿童医院骨科的30例肱骨远端骨骺分离的患儿的相关资料。其中，男25例，女5例；平均年龄为20.7个月，年龄范围为10~38个月；患侧为左侧10例，右侧20例。...

Comparison of ultrasound versus arthrography guided closed reduction and percutaneous pinning for transphyseal fracture of distal humerus

Objective To explore the clinical application of treating transphyseal fracture of distal humerus with closed reduction and percutaneous pinning under ultrasound/arthrography guidance in children.Methods From April 2013 to August 2017,the relevant clinical data were collected from 30 children hospitalized with distal humeral epiphyseal separation.There were 25 boys and 5 girls with a mean age of 20.7(10-38)months.The involved side was left(n=10)and right(n=20).Twelve children undergoing arthrography-assisted closed reduction and internal fixation were selected as groupⅠwhile another 18 undergoing ultrasound-assisted closed reduction and internal fixation as groupⅡ.General profiles and elbow joint function were compared between two groups.Flynn's elbow function was employed for evaluating elbow function during follow-ups and appearance was scored according to the angle of carrying angle reduction.The outcomes were excellent(range of carrying angle reduction 0°~5°),decent(range of carrying angle reduction 6°~10°),fair(range of carrying angle reduction 11°~15°)and poor(degree of carrying angle reduction>15°).Based upon the degree of flexion and extension function reduction,function was judged as excellent(flexion and extension function reduction range of 0°~5°),decent(flexion and extension function reduction range of 6°~10°),fair(flexion and extension function reduction range of 11°~15°)and poor(flexion and extension function reduction>15°).Results No significant inter-group differences existed in gender,age or preoperative injury time(P>0.05).The inter-group differences in frequency of intraoperative fluoroscopy and operative duration had statistical significance(P<0.05).The average follow-up period was 28(19-56)months.No significant inter-group difference existed in joint range-of-motion or Flynn function score.The average reduction angle of postoperative carrying angle was 5.0°in groupⅡand 2.2°in groupⅡ.There was no significant inter-group difference.Needle displacement(n=2,groupⅠ;n=1,groupⅡ)and cubitus varus(n=2,groupⅠ;n=1,groupⅡ)occurred.There was no significant inter-group difference.Neither groups had such postoperative complications as nonunion or pin tract infection.Conclusions Both ultrasound and arthrography assisted closed reduction and internal fixation in the treatment of distal humerus epiphysiolysis may achieve definite efficacy with low complications and an excellent recovery of joint function in children.Ultrasound-assisted closed reduction and internal fixation offers the advantages of shortening operative duration and reducing the frequency of intraoperative fluoroscopy.