Abstract：
OBJECTIVE: The primary objective of the present study is to compare the radiographic outcomes and complications of two different techniques for lateral closing-wedge osteotomy in pediatric patients with cubitus varus.
METHODS: We retrospectively identified patients treated at five tertiary care institutions: 17 underwent the Kirschner-wire (KW) technique, and 15 patients were treated with the mini external fixator (MEF) technique. Demographic data, previous treatment, pre- and postoperative carrying angle (CA), complications and additional procedures were recorded. Radiographic evaluation included assessment of the humerus-elbow-wrist angle (HEW), and the lateral prominence index (LPI).
RESULTS: Patients treated with both KW and MEF achieved significant improvements in clinical alignment (mean pre-op CA -16 ± 6.1 degrees to mean post-op 8.9 ± 5.3 degrees, P < 0.001). There were no differences in final radiographic alignment or radiographic union time; however, time to achieve full elbow motion was faster in the MEF group (13.6 versus 34.3 weeks, P = 0.4547). Two patients (11.8%) in the KW group experienced complications, including one superficial infection and one failed correction that required unplanned revision surgery. Eleven patients in the MEF group underwent a planned second surgical procedure for hardware removal.
CONCLUSIONS: Both fixation techniques are effective at correcting cubitus varus in the pediatric population. The MEF technique may have the advantage of shorter recovery of elbow range of motion but may require sedation for hardware removal. The KW technique may present a slightly higher complication rate.
METHODS: We retrospectively identified patients treated at five tertiary care institutions: 17 underwent the Kirschner-wire (KW) technique, and 15 patients were treated with the mini external fixator (MEF) technique. Demographic data, previous treatment, pre- and postoperative carrying angle (CA), complications and additional procedures were recorded. Radiographic evaluation included assessment of the humerus-elbow-wrist angle (HEW), and the lateral prominence index (LPI).
RESULTS: Patients treated with both KW and MEF achieved significant improvements in clinical alignment (mean pre-op CA -16 ± 6.1 degrees to mean post-op 8.9 ± 5.3 degrees, P < 0.001). There were no differences in final radiographic alignment or radiographic union time; however, time to achieve full elbow motion was faster in the MEF group (13.6 versus 34.3 weeks, P = 0.4547). Two patients (11.8%) in the KW group experienced complications, including one superficial infection and one failed correction that required unplanned revision surgery. Eleven patients in the MEF group underwent a planned second surgical procedure for hardware removal.
CONCLUSIONS: Both fixation techniques are effective at correcting cubitus varus in the pediatric population. The MEF technique may have the advantage of shorter recovery of elbow range of motion but may require sedation for hardware removal. The KW technique may present a slightly higher complication rate.
摘要：
目的：本研究的主要目的是比较两种不同的外侧闭合楔形截骨技术在小儿肘内翻患者中的影像学结果和并发症。
方法：我们回顾性地确定了在五家三级护理机构接受治疗的患者：17例接受了Kirschner-wire（KW）技术，15例患者接受微型外固定器（MEF）技术治疗。人口统计数据,以前的治疗,术前和术后携带角（CA），记录并发症和其他手术.影像学评估包括评估肱骨-肘部-腕部角度（HEW），和横向突出指数(LPI)。
结果：接受KW和MEF治疗的患者在临床对准方面取得了显着改善（平均术前CA-16±6.1度至平均术后8.9±5.3度，P<0.001)。最终射线照相对齐或射线照相结合时间没有差异；但是，MEF组实现肘部完全运动的时间更快(13.6对34.3周,P=0.4547）。KW组2例(11.8%)出现并发症,包括1例浅表感染和1例需要进行非计划翻修手术的矫正失败。MEF组中的11名患者接受了计划中的第二次手术以去除硬件。
结论：两种固定技术均可有效纠正儿科人群的肘内翻。MEF技术可能具有肘部运动范围恢复较短的优点，但可能需要镇静以移除硬件。KW技术可能会出现较高的并发症发生率。
方法：我们回顾性地确定了在五家三级护理机构接受治疗的患者：17例接受了Kirschner-wire（KW）技术，15例患者接受微型外固定器（MEF）技术治疗。人口统计数据,以前的治疗,术前和术后携带角（CA），记录并发症和其他手术.影像学评估包括评估肱骨-肘部-腕部角度（HEW），和横向突出指数(LPI)。
结果：接受KW和MEF治疗的患者在临床对准方面取得了显着改善（平均术前CA-16±6.1度至平均术后8.9±5.3度，P<0.001)。最终射线照相对齐或射线照相结合时间没有差异；但是，MEF组实现肘部完全运动的时间更快(13.6对34.3周,P=0.4547）。KW组2例(11.8%)出现并发症,包括1例浅表感染和1例需要进行非计划翻修手术的矫正失败。MEF组中的11名患者接受了计划中的第二次手术以去除硬件。
结论：两种固定技术均可有效纠正儿科人群的肘内翻。MEF技术可能具有肘部运动范围恢复较短的优点，但可能需要镇静以移除硬件。KW技术可能会出现较高的并发症发生率。
