Abstract：
OBJECTIVE: To compare screw versus Kirschner wire fixation in the treatment of lateral humeral condyle fractures in children.
METHODS: A systematic search was conducted in PubMed, Embase, the Cochrane library, Web of Science, China National Knowledge Internet(CNKI), Wanfang Datebase from in ception to February 2022. Studies comparing screws and Kirschner wire fixation in the treatment of lateral humeral condyle fractures in children were included. Outcome measures included and excluded by a set of inclusion and exclusion criteria and evaluated for their quality, their excellent and good rate of fracture healing, malunion, delayed union or nonunion, infection, limitation of elbow flexion or extension(>10°) were extracted and analyzed using software Rev Man 5.3.
RESULTS: A total of 9 retrospective studies involving 647 patients were included, with 255 patients in the screw fixation group(including screw combined with Kirschner wire) and 392 patients in the Kirschner wire fixation group. Meta analysis showed the following:infection rate in the screw group was significantly lower than that in the Kirschner wire group[OR=0.22, 95%CI(0.09, 0.56), P=0.001]. There were no significant differences between the 2 groups in excellent and good rate of fracture healing, malunion rate(P>0.05). Subgroup analysis showed that infection rate in the screw-only group was significantly lower than that in the Kirschner wire group[OR=0.18, 95%CI(0.05, 0.65), P=0.009].
CONCLUSIONS: For lateral humeral condyle fractures, Screw fixation alone had a lower infection rate than kirschner wire fixation and screw combined with Kirschner wire fixation. There were no significant differences in the excellent and good rate of fracture healing, malunion. In terms of postoperative efficacy and safety of internal fixation, orthopaedic surgeons are more likely to recommend screws for fixation of lateral humeral condyle fractures in children.
METHODS: A systematic search was conducted in PubMed, Embase, the Cochrane library, Web of Science, China National Knowledge Internet(CNKI), Wanfang Datebase from in ception to February 2022. Studies comparing screws and Kirschner wire fixation in the treatment of lateral humeral condyle fractures in children were included. Outcome measures included and excluded by a set of inclusion and exclusion criteria and evaluated for their quality, their excellent and good rate of fracture healing, malunion, delayed union or nonunion, infection, limitation of elbow flexion or extension(>10°) were extracted and analyzed using software Rev Man 5.3.
RESULTS: A total of 9 retrospective studies involving 647 patients were included, with 255 patients in the screw fixation group(including screw combined with Kirschner wire) and 392 patients in the Kirschner wire fixation group. Meta analysis showed the following:infection rate in the screw group was significantly lower than that in the Kirschner wire group[OR=0.22, 95%CI(0.09, 0.56), P=0.001]. There were no significant differences between the 2 groups in excellent and good rate of fracture healing, malunion rate(P>0.05). Subgroup analysis showed that infection rate in the screw-only group was significantly lower than that in the Kirschner wire group[OR=0.18, 95%CI(0.05, 0.65), P=0.009].
CONCLUSIONS: For lateral humeral condyle fractures, Screw fixation alone had a lower infection rate than kirschner wire fixation and screw combined with Kirschner wire fixation. There were no significant differences in the excellent and good rate of fracture healing, malunion. In terms of postoperative efficacy and safety of internal fixation, orthopaedic surgeons are more likely to recommend screws for fixation of lateral humeral condyle fractures in children.
摘要：
目的：比较螺钉与克氏针内固定治疗儿童肱骨髁外侧骨折的疗效。
方法：在PubMed中进行了系统搜索，Embase,科克伦图书馆,WebofScience,中国国民知识互联网(CNKI),万方数据库从感知到2022年2月。包括比较螺钉和克氏针固定治疗儿童肱骨髁外侧骨折的研究。通过一套纳入和排除标准纳入和排除的结果措施，并对其质量进行评估，他们的良好的骨折愈合率，malunion,延迟工会或不工会，感染,使用RevMan5.3软件提取并分析肘关节屈伸限制(>10°)。
结果：共纳入9项回顾性研究，涉及647例患者，螺钉固定组(包括螺钉联合克氏针)255例,克氏针固定组392例。Meta分析显示:螺钉组感染率明显低于克氏针组[OR=0.22,95CI(0.09,0.56),P=0.001]。2组骨折愈合优良率差异无统计学意义。畸形愈合率(P>0.05)。亚组分析显示，仅螺钉组的感染率明显低于克氏针组[OR=0.18，95CI（0.05，0.65），P=0.009]。
结论：对于肱骨髁外侧骨折，单独螺钉固定的感染率低于克氏针固定和螺钉联合克氏针固定的感染率。骨折愈合优良率差异无统计学意义,Malunion.在内固定术后疗效和安全性方面,骨科医生更有可能推荐使用螺钉固定儿童肱骨髁外侧骨折。
方法：在PubMed中进行了系统搜索，Embase,科克伦图书馆,WebofScience,中国国民知识互联网(CNKI),万方数据库从感知到2022年2月。包括比较螺钉和克氏针固定治疗儿童肱骨髁外侧骨折的研究。通过一套纳入和排除标准纳入和排除的结果措施，并对其质量进行评估，他们的良好的骨折愈合率，malunion,延迟工会或不工会，感染,使用RevMan5.3软件提取并分析肘关节屈伸限制(>10°)。
结果：共纳入9项回顾性研究，涉及647例患者，螺钉固定组(包括螺钉联合克氏针)255例,克氏针固定组392例。Meta分析显示:螺钉组感染率明显低于克氏针组[OR=0.22,95CI(0.09,0.56),P=0.001]。2组骨折愈合优良率差异无统计学意义。畸形愈合率(P>0.05)。亚组分析显示，仅螺钉组的感染率明显低于克氏针组[OR=0.18，95CI（0.05，0.65），P=0.009]。
结论：对于肱骨髁外侧骨折，单独螺钉固定的感染率低于克氏针固定和螺钉联合克氏针固定的感染率。骨折愈合优良率差异无统计学意义,Malunion.在内固定术后疗效和安全性方面,骨科医生更有可能推荐使用螺钉固定儿童肱骨髁外侧骨折。
