人为提高儿童肱骨髁上骨折外侧克氏针出针点的可行性及置针经验分析

目的 初步探讨人为提高儿童肱骨髁上骨折外侧克氏针出针点的可行性及其相应的置入方法 .方法 本研究分为两个阶段.第一阶段:收集2016年3月至2016年12月中国医科大学附属盛京医院161例儿童伸直型肱骨髁上骨折外侧针构型病例术中透视图像中最外侧针的出针点和入针点位置,测量最外侧针冠状面和矢状面钢针角度.第二阶段(201...

The feasibility and pinning expieriance of elevating the exit points of the proximal lateral pins in lateal pinning

Objective To explore the highest exit height of the proximal lateral pins in lateral pinning and find out how to achieve a higher exit with proximal lateral pins.Methods In stage one of the study:form March 2016 to December 2017,the entry and exit points of the proximal pins of lateral pinning configuration were analyzed from intra-operative radiographs of children treated for extension-type supracondylar humerus fractures.The coronal and sagittal pin angles formed by the proximal pins were also measured.In stage two(from January 2017 to December 2017),Using the findings of stage one,two surgeons intentionally tried to achieve a more proximal exit with the proximal pins,while the other two surgeons continued to fix the fractures according to the regular,standard pinning protocol.Comparisons between groups of patients treated by random and intentional pinnings were donestatistically.Results In the first stage,47(29.2%)of the 161 proximal pins exited above the metaphyseal-diaphyseal junction(MDJ)region.Of these,85.1% entered from lateral and posterior to the ossific nucleus of the capitellum(ONC).The pin angles averaged 58.4°and 90.5°in the coronal and sagittal planes respectively.In the second stage,47(47/72,65.3%)proximal pins in the intended group exited above the MDJ region,while only 32(32/89,36%)in the contral group exited above the MDJ region.Conclusion With intention,the exit points of proximal pins in lateral pinning can be elevated safely and effectively.