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Bone cemented K-wire fixation versus elastic stable intramedullary nailing fixation of paediatric proximal humerus
Shibo Liu1,2, Yanlong Zhang1, Jinchao Cao1
1Department of Orthopedics Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, China.
Insights
External cemented K-wire fixation offers a reliable, minimally invasive treatment for pediatric proximal humerus fractures. This technique shows comparable bone healing and functional outcomes to elastic stable intramedullary nailing, with reduced surgical time and cost.
Area of Science:
- Orthopedic Surgery
- Pediatric Orthopedics
- Traumatology
Background:
- Pediatric proximal humerus fractures require effective treatment strategies.
- Comparing fixation techniques is crucial for optimizing patient outcomes.
Purpose of the Study:
- To compare external fixation (K-wires and bone-cement) with elastic stable intramedullary nailing for pediatric displaced proximal humerus fractures.
Main Methods:
- 72 children received K-wire and bone-cement fixation (Group A); 44 received elastic stable intramedullary nailing (Group B).
- Functional outcomes assessed via Disabilities of the Arm, Shoulder and Hand (QuickDASH) and Neer score.
- Patient satisfaction measured using a visual analogue scale.
Main Results:
- Bone healing occurred in 6.1±1.2 weeks (Group A) and 6.4±1.1 weeks (Group B).
- Surgical time averaged 33±9 minutes (Group A) vs. 54±12 minutes (Group B).
- Significant differences observed in operation duration, cost, and postoperative angle (P < .05).
Conclusions:
- External cemented K-wire fixation is a reliable alternative for severe pediatric proximal humerus fractures.
- This minimally invasive technique offers excellent functional results with minimal complications.
Background:
The objective of this study is to compare the treatments of pediatric displaced proximal humerus fractures with external-fixation technique using the combination of K-wires and bone-cement versus close reduction and internal fixation technique using elastic stable intramedullary nail.
Methods:
From April 2016 to March 2020, 72 children with proximal humeral fractures were allocated to group A and 44 children with proximal humeral fractures were allocated to group B. Patients in group A were treated with bone-cemented K-wire fixation, and patients in group B were treated with elastic stable intramedullary nailing. The function of the upper limb was assessed using the Shortened Version of the Disabilities of the Arm, Shoulder and Hand questionnaire and Neer score. Patient satisfaction was assessed using the 10-cm visual analogue scale.
Results:
Bone healing was achieved in group A and B after a mean time of 6.1 ± 1.2 and 6.4 ± 1.1 weeks, respectively. The mean surgical time of groups was 33 ± 9 and 54 ± 12 minutes, respectively. The mean Quick Disabilities of the Arm, Shoulder and Hand questionnaire score of groups were 0.5 ± 1.4 and 0.7 ± 1.5, respectively. Based on Neer score, we obtained 69 excellent and 3 good results in group A, and 41 excellent and 3 good results in group B. There were significant differences regarding duration of operation, cost of treatment, and postoperative angle at bone healing (P < .05).
Conclusions:
The external cemented K-wire fixation is a useful and reliable alternative technique for the treatment of severely displaced proximal humerus fractures in children. The technique is a minimally invasive procedure with minimal complications.
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