■弹性稳定髓内钉(ESIN)是治疗胫骨干骨干骨折的常用方法,但其在胫骨远端干骨干端交界处(DTDMJ)骨折中的应用一直存在争议。本研究旨在评估弹性稳定髓内钉-克氏针(E-K)技术治疗小儿DTDMJ骨折的临床疗效。为临床医生诊断和治疗此类骨折提供更好的临床决策。
■我们对2019年1月至2021年1月在我院接受治疗的3-9岁胫骨干骨干端接头处(DTDMJ)骨折患者进行了回顾性分析。根据他们的外科手术,他们被分为弹性稳定髓内钉-克氏针组(E-K)和ESIN组。人口统计数据,手术时间,临床结果,并发症,并记录影像学数据。
■该研究共包括57名患者,E-K组24例,ESIN组33例。有30名男性和27名女性。E-K组平均年龄(6.25±1.59)岁,ESIN组平均年龄(6.27±1.48)岁。两组在性别方面无显著差异,年龄,体重,从受伤到手术的时间,随访时间,受伤的一面,相关伤害,指甲部位感染,深部感染,取指甲时间(P>0.05)。两组均未出现骨不连或再骨折。与ESIN组相比,E-K组在最终随访时显示出明显较低的冠状面和矢状面角度值(P<0.001)。在E-K组中,最终随访冠状面角为2.67(1.09)°,而在ESIN组,为6.55(2.05)°。E-K组最终随访矢状面角度为3.12(1.54)°,ESIN组为7.58(1.48)°。两组在最初的术后X线片中显示良好的对准,差异无统计学意义。然而,在临床愈合期间,ESIN组表现出明显的位移,而E-K组的位移最小,显示显著的统计学差异(P<0.001)。两组在AOFAS联合功能评估方面差异有统计学意义(P=0.027)。
■E-K技术是治疗小儿DTDMJ骨折的可行选择,具有公认的临床疗效。它的优点包括简单的外科手术,安全,严重并发症发生率低。
UNASSIGNED: Elastic stable intramedullary nail (ESIN) is a commonly used method for treating diaphyseal fractures of the tibia, but its application in Distal Tibial Diaphyseal Metaphyseal Junction (DTDMJ) fractures has been a subject of controversy. This study aims to evaluate the clinical efficacy of the Elastic stable intramedullary nail-Kirschner wire (E-K) technique in treating pediatric DTDMJ fractures, providing better clinical decision-making for clinicians in diagnosing and treating such fractures.
UNASSIGNED: We conducted a retrospective analysis of patients aged 3-9 years who received treatment at our hospital from January 2019-January 2021 for distal tibial diaphyseal metaphyseal junction (DTDMJ) fractures. Based on their surgical procedures, they were categorized into the Elastic Stable Intramedullary Nail-Kirschner wire group (E-K) and the ESIN group. Demographic data, surgical duration, clinical outcomes, complications, and imaging data were recorded.
UNASSIGNED: The study included a total of 57 patients, with 24 cases in the E-K group and 33 cases in the ESIN group. There were 30 males and 27 females. The average age was (6.25 ± 1.59) years in the E-K group and (6.27 ± 1.48) years in the ESIN group. There were no significant differences between the two groups in terms of gender, age, weight, time from injury to surgery, follow-up time, side of injury, associated injuries, nail site infection, deep infection, and nail removal time (P > 0.05). Neither group experienced nonunion or refracture. The E-K group exhibited significantly lower coronal and sagittal plane angular values at the final follow-up compared to the ESIN group (P < 0.001). In the E-K group, the final follow-up coronal plane angle was 2.67 (1.09)°, while in the ESIN group, it was 6.55 (2.05)°. The final follow-up sagittal plane angle was 3.12 (1.54)° in the E-K group and 7.58 (1.48)° in the ESIN group. Both groups showed good alignment in the initial postoperative x-rays, with no statistically significant differences. However, during clinical healing, the ESIN group exhibited significant displacement, whereas the E-K group had minimal displacement, demonstrating a significant statistical difference (P < 0.001). There was a statistically significant difference in the AOFAS joint function assessment between the two groups (P = 0.027).
UNASSIGNED: The E-K technique is a viable option for treating DTDMJ fractures in pediatric patients, with well-established clinical efficacy. Its advantages include a straightforward surgical procedure, safety, and a low incidence of severe complications.