Introduction The aim of this was to analyze the effect of different treatment options on radial neck fractures in children and to explore the factors affecting the prognosis of fractures. Methods The clinical data of 131 children with radial neck fractures admitted to our hospital from 2010 to 2018 were retrospectively analyzed, and the patients were divided into 6 groups according to treatment methods [manual reduction with Kirschner wires (K-wires) for internal fixation (group A); manual reduction with elastic stable intramedullary nails (ESINs) for internal fixation (group B); leverage reduction with K-wires for internal fixation (group C); leverage reduction with ESINs for internal fixation (group D); manual and leverage reduction with K-wires/ESINs for internal fixation (group E); and open reduction with K-wires/ESINs for internal fixation (group F)]. Postoperative elbow function and complications were analyzed. Results Among the 131 patients with fractures, the median age was 8 years, the median preoperative angulation was 52°, the follow-up rate was 86.3% (113/131), the average follow-up time was 58.3 months, and the postoperative complication rate was 17.7% (20/113). The comparison among the different treatment groups showed that group B had the best recovery of elbow function, postoperatively, and the lowest postoperative complication rate. Age, duration of hospitalization, and preoperative angulation were independent factors affecting postoperative complications. Older age, longer duration of hospitalization, and higher angulation increase the postoperative complications. Conclusion Different treatment options have different efficacies for radial neck fractures in children, of which manipulative reduction with internal fixation using ESINs can achieve good efficacy and a low postoperative complication rate. Age, duration of hospitalization, and preoperative angulation are independent factors for postoperative complications.
Background The purpose of this study was to introduce the arthroscopic internal drainage with anterior-anteromedial approach for the treatment of popliteal cysts in children. To compare its clinical efficacy with open surgery. Methods This was a retrospective case–control study of 102 patients diagnosed with popliteal cysts from January 2018 to February 2020 who received surgery. The study included 27 cases with minimally invasive group (MI group) and 75 cases with open surgery group (OS group). The MI group included 21 males and 6 females, age 6.71 ± 2.16 years who received arthroscopic internal drainage of the cysts to adequately widen the valve opening between the cyst and the articular cavity, excised the fibrous diaphragm without complete excision of the cyst wall. The OS group included 57 males and 18 females, age 6.21 ± 1.67 years who received open excision. The clinical parameters regarding the preoperative characteristics and surgical results were compared. Ultrasound or MRI was used to identify the recurrence of the popliteal cysts. Rauschning-Lindgren grade was recorded to evaluate the clinical outcome. Results All patients were followed up for at least 24 months. There were no significant differences between the two groups in age, gender, left and right sides, disease time, cyst size, length of hospitalization, preoperative Rauschning-Lindgren grade (p > 0.05). At the last follow-up, the preoperative and postoperative Rauschning-Lindgren grade was improved in both groups. Compared with the OS group, operation time was significantly shortened in the MI group (28.89 ± 4.51 min vs 52.96 ± 29.72 min, p < 0.05). The MI group was superior to the OS group in terms of blood loss and plaster fixation, with statistical significance (p < 0.05). There was obvious difference in recurrence rate between the two groups (0% vs 17.33%, p = 0.018). No postoperative complications occurred during the follow-up period. Conclusions Compared with open excision, the treatment of popliteal cyst in children by arthroscopic internal drainage to expand the articular cavity and eliminate the “one-way valve” mechanism between the cyst and the articular cavity exhibits better clinical outcomes and significantly reduces the recurrence rate, which is worthy of further clinical promotion.
Objective To measure the morphological parameters of the normal meniscus in children and provide a reference for diagnosing and treating children's meniscus-related diseases. Methods The imaging data of children who underwent 3.0T knee joint magnetic resonance plain scan were retrospectively analyzed, and the children were divided into group A, group B, group C, and group D according to age. Fifty children were randomly selected in each group, with 200 knee joints, including 400 menisci (200 cases on the inner side and 200 cases on the outer side). Retrieve T2WI images, measure tibial plateau width (TPW), medial tibial plateau width (MTPW), lateral tibial plateau width (LTPW), tibial intercondylar ridge width (TIRW), tibial intercondylar ridge height (TIRH), lateral meniscus body thickness (LMBT), lateral meniscus body width (LMBW), medial meniscus body thickness (MMBT), and medial meniscus body width (MMBW) on the coronal plane; in the sagittal plane, measure the lateral meniscus anterior horn thickness (LMAT), lateral meniscal anterior horn width (LMAW), lateral meniscal posterior horn thickness (LMPT), lateral meniscal posterior horn width (LMPW), lateral meniscal sagittal diameter (LMSD), medial meniscal posterior horn Thickness (MMAT), medial meniscal anterior horn width (MMAW), medial meniscal posterior horn thickness (MMPT), medial meniscal posterior horn width (MMPW), and medial meniscal sagittal diameter (MMSD). They were divided into groups by age, sex, inside and outside, and statistical analysis was carried out. P < 0.05 was considered statistically significant. Results We obtained morphological data on the meniscus (anterior horn, body, and posterior horn), tibial plateau, and tibial intercondylar ridge in children of all ages. Through pairwise comparisons between age groups, we found that the indicators of group A are smaller than those of group B (except LMAT), and group B's indicators are lower than group C's (except TIRW). However, in the comparison between group C and group D, there was no statistical difference in some meniscus indexes (LMBT, LMPW, LMSD, MMAT, MMBT, MMPT; P values were 0.15, 0.70, 0.38, 0.13, 0.82, 0.16, respectively), and the rest The meniscus-related indicators in group C were greater than those in group D (LMAT, LMAW, LMBW, LMPT, MMAW, MMBW, MMPW, MMSD); the data of tibial plateau and intercondylar crest in group C were smaller than those in group D (TPW, LTPW, MTPW, TIRW ). The comparison of the inner and outer meniscus shows obvious differences in shape between the two. Through gender group comparison, we found that the meniscus morphology parameters of men and women were consistent. Conclusion We obtained the morphological data of the normal meniscus, tibial plateau, and tibial intercondylar ridge in children, which provides a reference for the diagnosis and treatment of meniscus diseases. Within the range of 0–15 years old, the meniscus gradually increases with growth and development; after 15 years old, the meniscus no longer increases, and some areas show degeneration. The lateral meniscus is generally larger than the medial meniscus. There was no significant correlation between meniscal shape and gender.
BackgroundCapitellum fractures are rare coronal fractures of the distal humerus which accounts for 6% of all distal humeral fractures and only 1% of all elbow fractures. The purpose of this study was to investigate the efficacy and complications of arthroscopically assisted reduction and fixation with absorbable screws for capitellar fracture of the humerus in children.MethodsThis was a retrospective case series study, which considered four patients (4 elbows), ranging from 10 to 15 years old, who were treated by arthroscopic-assisted percutaneous absorbable screw between 2018 and 2020. The elbow flexion-extension and forearm supination-pronation ranges of motion (ROM) were measured at the preoperative examination and last follow-up examination. Finally, the clinical and radiological results were assessed.ResultsThe result of operations is satisfactory. The mean follow-up was 3.0 years (range 2–3.8 years). Average range of motion significantly improved from pre- to postoperation, with forearm supination from 60°(50°−60°) to 90°(90°) and pronation improved from 75°(70°−80°) to 90°(90°). The postoperative elbow flexion-extension range of motion was significantly higher compared with range of motion before surgery (P < 0.001; r = 0.949). At the final follow-up examination, the Mayo Elbow Performance Score was excellent. Satisfactory clinical results were achieved in all patients, and no postoperative complications were observed.ConclusionsIt is an effective and safe surgical option to use arthroscopic-assisted percutaneous absorbable screw fixation for treating capitellum fracture of the humerus without any complications in children.Level of evidenceLevel IV; case series.
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