Objective: To compare the effectiveness of ultrasound- and arthrography-assisted Kirschner wire fixation in the treatment of Jakob type Ⅱ lateral condylar humerus fracture (LCHF) in children.
Methods: A clinical data of 101 children with Jakob type Ⅱ LCHF, who met the selection criteria and were admitted between April 2021 and April 2022, was retrospectively analyzed. Of them, 47 cases were treated with ultrasound-assisted Kirschner wire fixation (group A), and 54 cases with arthrography-assisted surgery (group B). There was no significant difference in gender, age, cause of injury, fracture side, and disease duration between groups (P>0.05). Intraoperative fluoroscopy times, operation time, and hospital stay, Flynn elbow joint function score, and postoperative complications were recorded and compared between groups. X-ray examination was performed to observe the healing of fracture, and measure the carrying angle and the shaft-condylar angle (SCA).
Results: The success rate of closed reduction was significantly higher in group A than in group B (P<0.05), and the intraoperative fluoroscopy times was significantly less in group A than in group B (P<0.05). There was no significant difference in operation time and hospital stay between groups (P>0.05). All children in both groups were followed up 12-18 months, with an average of 13.6 months. X-ray reexamination showed that the fractures of both groups healed, and the difference in healing time was not significant (P>0.05). At last follow-up, there was no significant difference in carrying angle and SCA between unaffected side and affected side in both groups and between groups A and B in affected side (P>0.05). There was no significant difference in Flynn elbow joint function score between groups (P>0.05). There were 18 cases of lateral spurs formation in group A, 1 case of pinning infection and 26 cases of lateral spurs formation in group B, and there was no significant difference in the incidence of the above complications (P>0.05).
Conclusion: Compared with the arthrography, the ultrasound-assisted Kirschner wire fixation in the treatment of Jakob type Ⅱ LCHF in children can avoid the open reduction and decrease the number of intraoperative fluoroscopy, and obtain the good effectiveness.
目的: 比较超声与关节造影辅助克氏针内固定治疗儿童JakobⅡ型肱骨外髁骨折（lateral condylar humerus fracture，LCHF）的疗效。.
方法: 回顾分析2021年4月—2022年4月收治且符合选择标准的101例儿童Jakob Ⅱ型LCHF临床资料。其中47例采用超声辅助克氏针内固定治疗（A组），54例采用关节造影辅助克氏针内固定治疗（B组）。两组患儿性别、年龄、致伤原因、骨折侧别及病程等基线资料比较，差异均无统计学意义（P>0.05）。记录并比较两组术中透视次数、手术时间以及住院时间，Flynn肘关节功能评分，术后并发症发生情况；X线片检查观察骨折愈合情况，测量提携角、髁干角（shaft-condylar angle，SCA）。.
结果: A组闭合复位成功率高于B组，术中透视次数少于B组，差异均有统计学意义（P<0.05）。两组手术时间及住院时间比较，差异均无统计学意义（P>0.05）。两组患儿均获随访，随访时间12～18个月，平均13.6个月。X线片复查示两组骨折均愈合，愈合时间差异无统计学意义（P>0.05）；末次随访时A、B组组内健、患侧提携角、SCA间差异无统计学意义（P>0.05），组间患侧提携角和SCA差异亦无统计学意义（P>0.05）。末次随访时，两组Flynn肘关节功能评分差异无统计学意义（P>0.05）。随访期间，A组发生肱骨外侧骨突形成18例，B组发生针道感染1例、肱骨外侧骨突形成26例；上述并发症发生率比较，差异均无统计学意义（P>0.05）。.
结论: 与关节造影相比，超声辅助克氏针内固定治疗儿童Jakob Ⅱ型LCHF，可降低切开复位率，减少术中透视次数，获得较好疗效。.
Keywords: Lateral condylar humerus fracture; arthrography; child; internal fixation; ultrasound.