Objective Supracondylar humerus fractures are the most frequent fractures of the paediatric elbow.The present study introduced a modified surgical procedure for treatment of supracondylar humerus fractures in children...Objective Supracondylar humerus fractures are the most frequent fractures of the paediatric elbow.The present study introduced a modified surgical procedure for treatment of supracondylar humerus fractures in children.Methods From February 2015 to August 2019,73 patients with Gartland’s type II and III supracondylar fractures were treated with this modified method.Totally,68 of all patients were followed up for 3–12 months(mean 8.25 months).The evaluation results included fracture nonunion,ulnar nerve injury,pin track infection,carrying angle and elbow joint Flynn score.Results The results showed that bone union was observed in all children,one case had an iatrogenic ulnar nerve injury,and the symptoms were completely relieved in 4 months after removing of the medial-side pin.All children had no cubitus varus deformity and no pin track infection,and the rate of satisfactory results according to Flynn’s criteria score was 100%.Conclusion The modified closed reduction and Kirschner wires internal fixation could effectively reduce the rate of open reduction,the risk of iatrogenic ulnar nerve injury,and the incidence of cubitus varus deformity in treatment of supracondylar humerus fractures in children.展开更多
The Kirschner wires (K-wires) are stiff and straight wires made of smooth stainless steel. These are used in surgery to aid in repairing the process of a fractured bone. In forefoot elective surgeries, these pins are ...The Kirschner wires (K-wires) are stiff and straight wires made of smooth stainless steel. These are used in surgery to aid in repairing the process of a fractured bone. In forefoot elective surgeries, these pins are mostly used for fixation of the phalangeal or metatarsal area. These wires are usually either buried or exposed, The exposed wires do not require another operation to remove them and are generally preferred. In using the forefoot surgery history of a single surgeon which was taken for 3 years<span>.</span><span> The purpose of this study is to evaluate the occurrence of infections following elective surgeries of the forefoot that were fixed using k-pins and to indicate an effective treatment option for resolving the infection. The inclusion criteria set for this study was to remove any patient having any disease except for diabetes. Moreover, the age limit was set to be 18</span><span> </span><span>-</span><span> </span><span>44, making a final sample of 50 people, prescribed prophylactic antibiotics or early removal of k-pins, where necessary. The researcher recorded demographic and biological data from the patients such as age, BMI, and smoking status were recorded. The researcher conducted a Univariate analysis via a Chi-square test. 50</span><b><span> </span></b><span>Patients (82 K-wires) were analyzed. Results showed that surgery type, BMI, and smoking were three variables that affect the infection growth significantly while diabetes and type of cleaning disinfectant had marginal effects. Further study is required to clarify the best treatments in this area, as the treatment option antibiotics have nearly similar results.</span>展开更多
The incidence of metatarsal fractures is not precisely known. Malposition might cause future metatarsalgia, mid-foot pain and discomfort, which may dictate an on-going need for in-shoe orthosis, shoe modification and,...The incidence of metatarsal fractures is not precisely known. Malposition might cause future metatarsalgia, mid-foot pain and discomfort, which may dictate an on-going need for in-shoe orthosis, shoe modification and, occasionally, operative correction. To minimize and prevent these problems, we describe a simple technique for reduction and fixation of metatarsal fractures by Kirschner wires. We have found this technique to be a simple and efficient way of reducing and fixing metatarsal fractures. It is applied easily by the closed and open technique.展开更多
Objective: To evaluate the feasibility of the pedicle screw pilot holes placement in thoracic spine using the spiral wires as the guide pin. Methods: The pedicle screw pilot holes were drilled within the center of the...Objective: To evaluate the feasibility of the pedicle screw pilot holes placement in thoracic spine using the spiral wires as the guide pin. Methods: The pedicle screw pilot holes were drilled within the center of the pedicle and the lateral and medial pedicle walls were violated in 9 human dried thoracic vertebrae. Kirschner wires or spiral wires were separately placed in the holes, and then the posteroanterior and lateral radiographs were taken. The radiographs were evaluated by 3 experienced spine surgeons and 3 young orthopedists. After radiographs were shown to these observers, they combined the posteroanterior and lateral radiographs in each place and determined whether the pedicle screw pilot hole violated the pedicle cortex or not. The results were analyzed by a statistical software. Results: Sensitivity, specificity and accuracy of the method using spiral wires to detect pedicle pilot hole placement were significantly higher than those of using Kirschner wires. With a true posteroanterior radiograph, the sensitivity, specificity and accuracy of the method using spiral wires approximated or attained 100%. Conclusions: The method of intrapedicular pilot hole placement verification using spiral wires is effective for guiding the accurate placement of pedicle screws.展开更多
Purpose： To evaluate the efficacy of intramedullary Kirschner wires for the treatment of unstable tibial shaft fractures in children. Methods： This prospective study was conducted at the Department of Orthopaedic Su...Purpose： To evaluate the efficacy of intramedullary Kirschner wires for the treatment of unstable tibial shaft fractures in children. Methods： This prospective study was conducted at the Department of Orthopaedic Surgery in Maharishi Markandeshwar Medical College from June 2005 to June 2010. Sixty-six children having closed fracture of the tibial shaft with a mean age of 7.7 years （range, 2-14 years） were recruited from emergency and outpatient department. They were treated with percutaneous intramedullary Kirschner wires. The clinical results of our study were rated on the basis of the criteria of union, nonunion, delayed union or malunion. All children were followed for one year. Results： Children achieved union in a mean time of 8 weeks （range, 6-10 weeks）. Postoperatively, three children （4.55%） had delayed union, one （1.52%） valgus deformity of lower leg, three （4.55%） post- operative knee pain and twelve （18.18%） skin irritation at pin site. Wires were removed after 8-22 weeks without any complications. No patient was lost to follow-up. The results were excellent in 95.45% and good in 4.55% children. Conclusion： This technique is cost-effective, simple, quick to perform, safe and reliable and avoids pro- longed hospitalization with good results.展开更多
目的:通过Meta分析系统评价螺钉及克氏针内固定治疗儿童肱骨外髁骨折的临床疗效。方法:计算机检索PubMed、Embase、Cochrane、Web of Science、中国知网、万方数据库建库至2022年2月国内外发表的有关螺钉和克氏针内固定治疗儿童肱骨外...目的:通过Meta分析系统评价螺钉及克氏针内固定治疗儿童肱骨外髁骨折的临床疗效。方法:计算机检索PubMed、Embase、Cochrane、Web of Science、中国知网、万方数据库建库至2022年2月国内外发表的有关螺钉和克氏针内固定治疗儿童肱骨外髁骨折的文献。根据设定的纳入与排除标准筛选文献并进行质量评价,结局指标为愈合优良率、畸形愈合率、延迟愈合率或骨不连率、感染率、活动受限(>10°)发生率,使用RevMan 5.3软件进行统计分析。结果:共纳入9项回顾性研究涉及647例患者,其中螺钉固定组(含螺钉联合克氏针)255例,克氏针固定组392例。Meta分析显示,与克氏针组相比,螺钉组(含螺钉联合克氏针)在术后有更低的感染率[OR=0.22,95%CI(0.09,0.56),P=0.001]。两组间愈合优良率、畸形愈合率比较,差异均无统计学意义(P>0.05)。亚组分析显示,单纯螺钉组术后感染率显著低于克氏针组[OR=0.18,95%CI(0.05,0.65),P=0.009]。结论:对于手术治疗儿童肱骨外髁骨折,与克氏针内固定和螺钉联合克氏针内固定相比,单纯螺钉内固定拥有更低的感染率。而在愈合优良率、畸形愈合率方面三者无显著差异。就术后疗效及内固定安全性方面而言,更推荐骨科医师使用螺钉进行儿童肱骨外髁骨折的固定。展开更多
基金supported by Program of the National Natural Science Foundation of China(No.82074233)Scientific Research Foundation for Advanced Talents,Xiang’an Hospital of Xiamen University(No.PM201809170009).
文摘Objective Supracondylar humerus fractures are the most frequent fractures of the paediatric elbow.The present study introduced a modified surgical procedure for treatment of supracondylar humerus fractures in children.Methods From February 2015 to August 2019,73 patients with Gartland’s type II and III supracondylar fractures were treated with this modified method.Totally,68 of all patients were followed up for 3–12 months(mean 8.25 months).The evaluation results included fracture nonunion,ulnar nerve injury,pin track infection,carrying angle and elbow joint Flynn score.Results The results showed that bone union was observed in all children,one case had an iatrogenic ulnar nerve injury,and the symptoms were completely relieved in 4 months after removing of the medial-side pin.All children had no cubitus varus deformity and no pin track infection,and the rate of satisfactory results according to Flynn’s criteria score was 100%.Conclusion The modified closed reduction and Kirschner wires internal fixation could effectively reduce the rate of open reduction,the risk of iatrogenic ulnar nerve injury,and the incidence of cubitus varus deformity in treatment of supracondylar humerus fractures in children.
文摘The Kirschner wires (K-wires) are stiff and straight wires made of smooth stainless steel. These are used in surgery to aid in repairing the process of a fractured bone. In forefoot elective surgeries, these pins are mostly used for fixation of the phalangeal or metatarsal area. These wires are usually either buried or exposed, The exposed wires do not require another operation to remove them and are generally preferred. In using the forefoot surgery history of a single surgeon which was taken for 3 years<span>.</span><span> The purpose of this study is to evaluate the occurrence of infections following elective surgeries of the forefoot that were fixed using k-pins and to indicate an effective treatment option for resolving the infection. The inclusion criteria set for this study was to remove any patient having any disease except for diabetes. Moreover, the age limit was set to be 18</span><span> </span><span>-</span><span> </span><span>44, making a final sample of 50 people, prescribed prophylactic antibiotics or early removal of k-pins, where necessary. The researcher recorded demographic and biological data from the patients such as age, BMI, and smoking status were recorded. The researcher conducted a Univariate analysis via a Chi-square test. 50</span><b><span> </span></b><span>Patients (82 K-wires) were analyzed. Results showed that surgery type, BMI, and smoking were three variables that affect the infection growth significantly while diabetes and type of cleaning disinfectant had marginal effects. Further study is required to clarify the best treatments in this area, as the treatment option antibiotics have nearly similar results.</span>
文摘The incidence of metatarsal fractures is not precisely known. Malposition might cause future metatarsalgia, mid-foot pain and discomfort, which may dictate an on-going need for in-shoe orthosis, shoe modification and, occasionally, operative correction. To minimize and prevent these problems, we describe a simple technique for reduction and fixation of metatarsal fractures by Kirschner wires. We have found this technique to be a simple and efficient way of reducing and fixing metatarsal fractures. It is applied easily by the closed and open technique.
文摘Objective: To evaluate the feasibility of the pedicle screw pilot holes placement in thoracic spine using the spiral wires as the guide pin. Methods: The pedicle screw pilot holes were drilled within the center of the pedicle and the lateral and medial pedicle walls were violated in 9 human dried thoracic vertebrae. Kirschner wires or spiral wires were separately placed in the holes, and then the posteroanterior and lateral radiographs were taken. The radiographs were evaluated by 3 experienced spine surgeons and 3 young orthopedists. After radiographs were shown to these observers, they combined the posteroanterior and lateral radiographs in each place and determined whether the pedicle screw pilot hole violated the pedicle cortex or not. The results were analyzed by a statistical software. Results: Sensitivity, specificity and accuracy of the method using spiral wires to detect pedicle pilot hole placement were significantly higher than those of using Kirschner wires. With a true posteroanterior radiograph, the sensitivity, specificity and accuracy of the method using spiral wires approximated or attained 100%. Conclusions: The method of intrapedicular pilot hole placement verification using spiral wires is effective for guiding the accurate placement of pedicle screws.
文摘Purpose： To evaluate the efficacy of intramedullary Kirschner wires for the treatment of unstable tibial shaft fractures in children. Methods： This prospective study was conducted at the Department of Orthopaedic Surgery in Maharishi Markandeshwar Medical College from June 2005 to June 2010. Sixty-six children having closed fracture of the tibial shaft with a mean age of 7.7 years （range, 2-14 years） were recruited from emergency and outpatient department. They were treated with percutaneous intramedullary Kirschner wires. The clinical results of our study were rated on the basis of the criteria of union, nonunion, delayed union or malunion. All children were followed for one year. Results： Children achieved union in a mean time of 8 weeks （range, 6-10 weeks）. Postoperatively, three children （4.55%） had delayed union, one （1.52%） valgus deformity of lower leg, three （4.55%） post- operative knee pain and twelve （18.18%） skin irritation at pin site. Wires were removed after 8-22 weeks without any complications. No patient was lost to follow-up. The results were excellent in 95.45% and good in 4.55% children. Conclusion： This technique is cost-effective, simple, quick to perform, safe and reliable and avoids pro- longed hospitalization with good results.
文摘目的:通过Meta分析系统评价螺钉及克氏针内固定治疗儿童肱骨外髁骨折的临床疗效。方法:计算机检索PubMed、Embase、Cochrane、Web of Science、中国知网、万方数据库建库至2022年2月国内外发表的有关螺钉和克氏针内固定治疗儿童肱骨外髁骨折的文献。根据设定的纳入与排除标准筛选文献并进行质量评价,结局指标为愈合优良率、畸形愈合率、延迟愈合率或骨不连率、感染率、活动受限(>10°)发生率,使用RevMan 5.3软件进行统计分析。结果:共纳入9项回顾性研究涉及647例患者,其中螺钉固定组(含螺钉联合克氏针)255例,克氏针固定组392例。Meta分析显示,与克氏针组相比,螺钉组(含螺钉联合克氏针)在术后有更低的感染率[OR=0.22,95%CI(0.09,0.56),P=0.001]。两组间愈合优良率、畸形愈合率比较,差异均无统计学意义(P>0.05)。亚组分析显示,单纯螺钉组术后感染率显著低于克氏针组[OR=0.18,95%CI(0.05,0.65),P=0.009]。结论:对于手术治疗儿童肱骨外髁骨折,与克氏针内固定和螺钉联合克氏针内固定相比,单纯螺钉内固定拥有更低的感染率。而在愈合优良率、畸形愈合率方面三者无显著差异。就术后疗效及内固定安全性方面而言,更推荐骨科医师使用螺钉进行儿童肱骨外髁骨折的固定。
