A prospective randomised non-blinded comparison of conventional and Dorgan's crossed pins for paediatric supracondylar humeral fractures
Autor: | Iva Brkić, Zoran I. Radojicic, Tatjana Jaramaz Dučić, Bojan Bukva, Hari Jurdana, Goran Vrgoč, Lovro Štefan, Vladimir Radlovic, Nikola Bojovic, Dusan Abramovic, Sinisa Ducic |
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Jazyk: | angličtina |
Rok vydání: | 2016 |
Předmět: |
Male
Humeral Fractures medicine.medical_specialty Percutaneous Bone Nails Fracture Fixation Internal 03 medical and health sciences 0302 clinical medicine Percutaneous pinning medicine Humans Surgical Wound Infection Prospective Studies BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Orthopedics Supracondylar humerus fracture 030212 general & internal medicine Ulnar nerve injury Child Children Fracture type Outcome General Environmental Science Procedure time 030222 orthopedics business.industry Infant Hospitals Pediatric medicine.disease Anti-Bacterial Agents 3. Good health Surgery Radiation exposure Treatment Outcome Type iib BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Ortopedija Child Preschool General Earth and Planetary Sciences Female business Bone Wires |
Zdroj: | Injury Volume 47 Issue 11 |
ISSN: | 0020-1383 |
Popis: | Background Closed reduction and percutaneous pinning are the preferred treatment of displaced supracondylar humeral fractures in children. The purpose of this study is to evaluate the non-standard Dorgan’s method and compare its results with those of the standard percutaneous cross pinning method in treatment of unstable or irreducible Gartland type II and III supracondylar humeral fractures in children. Patients and methods This was a prospective evaluation of 138 consecutive patients with Gartland type II or III extension supracondylar humeral fractures referred to University Children’s Hospital during a four-year period. The patients were randomized into two groups: the first group, comprised of 71 patients, was treated with standard pin configuration and the second group, comprised of 67 patients, underwent Dorgan’s method. The study included 88 boys and 50 girls aged 1.5–11.4 years (mean 6.5 ± 2). At initial presentation 8.7% (n-12) fractures were classified as Gartland type IIa, 25.4% (n-35) as Gartland type IIb and 65.9% (n-91) as Gartland type III. Results Flynn’s criteria were used to evaluate the results. An excellent clinical outcome was reported in about 90% of patients (n-90) treated with standard pin configuration and 89.5% (n-60) of patients treated with Dorgan’s method. There were no statistically significant differences in outcomes between the groups in terms of their gender, age, fracture types, function and cosmetics. Neurological lesions were observed in 9.9% of patients (n = 7) who were treated using the standard configuration Kirschner pins, while in those treated by Dorgan’s method neurological complications were not observed. However, the procedure time was longer (mean 36.54 ± 5.65 min) and radiation exposure significantly higher (mean 10.19 ± 2.70 exposures) in the group that was treated using Dorgan’s method, compared to the conventional method (mean 28.66 ± 3.76 min and 7.54 ± 1.63 exposures). Conclusion Two laterally inserted crossed pins provide adequate stability with good functional and cosmetic outcome for most unstable paediatric supracondylar humeral fractures with no risk of iatrogenic ulnar nerve injury. |
Databáze: | OpenAIRE |
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