目的:小儿肱骨髁上骨折(PSHFs)后肘内翻畸形(CVD)的三维(3D)重塑能力仍未阐明。这项研究通过检查受伤后随时间的3D畸形分布来调查PSHFs后的重塑模式。
方法:分析86例PSHFs后CVD患者的计算机断层扫描(CT)数据。三维畸形角度在矢状,日冕,评估和轴向方向,并与受伤年龄和CT评估之间的持续时间相关。对于子群分析,我们在年轻组(<8岁)和老年组(≥8岁)中进行了相同的相关性分析;我们将持续时间分为早期(<2年),中期(≥2至<5年),和晚期(≥5年),并比较三组各方向的畸形角度。
结果:矢状畸形与畸形持续时间呈中度相关(r=-0.54;P<0.001),而冠状和轴向畸形显示出微不足道的相关性。年轻组矢状畸形与病程呈中度相关(r=-0.62;P<0.001),老年组则呈弱相关(r=-0.37;P=0.091)。在矢状方向上,早期畸形角度明显大于中晚期(P<0.001)。然而,三组之间在冠状方向和轴向方向上没有显着差异。
结论:CVD的矢状畸形能够重塑,尤其是在早期和年轻的时候,而冠状和轴向畸形不太可能进行重塑。
OBJECTIVE: Three-dimensional (3D) capacity for remodelling in cubitus varus deformity (CVD) after paediatric supracondylar humeral fractures (PSHFs) remains unelucidated. This study investigated remodelling patterns after PSHFs by examining 3D deformity distribution over time after injury.
METHODS: Computed tomography (CT) data of 86 patients with CVD after PSHFs were analysed. The 3D deformity angles in the sagittal, coronal, and axial directions were assessed and correlated with the duration between the age at injury and CT evaluation. For the subgroup analysis, we performed the same correlation analysis in a younger (< 8 years old) and an older group (≥ 8 years old); we categorized the duration into early (< 2 years), middle (≥ 2 to < 5 years), and late periods (≥ 5 years) and compared the deformity angles of each direction among the three groups.
RESULTS: Sagittal deformity showed a moderate correlation with the duration of deformity (r = -0.54; P < 0.001), while coronal and axial deformities showed a negligible correlation. Sagittal deformity showed moderate correlations with the duration in the younger group (r = -0.62; P < 0.001) and weak correlations in the older group (r = -0.37; P = 0.091). In the sagittal direction, the deformity angle in the early period was significantly larger than those in the mid and late periods (P < 0.001). However, there were no significant differences among the three groups in the coronal and axial directions.
CONCLUSIONS: Sagittal deformities in CVDs are capable of remodelling, especially in the early period and at a younger age, whereas coronal and axial deformities are less likely to undergo remodelling.