To compare the efficacy of curettage and bone grafting combined with elastic intramedullary nailing (EIN) vs curettage and bone grafting in the treatment of long bone cysts in children and to clarify the necessity of using EIN in the treatment of bone cysts. Sixty-two patients were involved in this study from Jan. 2009 to Sept. 2017 (43 males, 19 females; 27 humeri, 35 femurs); the patients were assigned to an EIN group, comprising 30 patients who underwent curettage and bone grafting combined with EIN, or to a non–elastic intramedullary nailing (NEIN) group, comprising 32 patients who underwent curettage and bone grafting alone. The prognosis of the 2 groups was assessed with reference to the standard of Capanna. No statistically significant differences in sex, age, location, activity, pathological fracture, cyst volume, operative time and intraoperative blood loss were found between the 2 groups ( P > .05). The effective rate was 90.0% in the EIN group and 68.8% in the NEIN group, and the difference was statistically significant ( P < .05). Compared to simple curettage and bone grafting, curettage and bone grafting combined with EIN treatment can significantly improve the prognosis of children with bone cysts. It is recommended that EIN be added to bone cyst curettage and bone grafting.
Rationale: Osteochondral flap fractures of the elbow are rare in children. To the best of our knowledge, only 12 cases are reported in the literature. Only 1 case was accompanied with lateral condyle fracture classified as Milch I, which was nondisplaced. The mechanism of these injuries is not explained in detail, and the treatment methods are not discussed. Here, we present 3 cases of osteochondral flap fracture of the ulnar coronoid process with accompanying obvious displacement of the lateral condyle fracture. Patient concerns: All patients fell into one of their outstretched arms, which caused elbow pain and functional limitation. Diagnosis: All 3 patients were diagnosed with lateral condyle fracture of the humerus and osteochondral flap fracture of the ulnar coronoid process. Interventions: All patients underwent open reduction and internal fixation. Outcomes: At 3 months after the operation, they regained full range of motion of the limb and had no elbow instability. Lessons: Osteochondral flap fracture should be considered when there is a bone mass in the elbow space with accompanying displacement of the humeral lateral condyle fracture.
Background: The application of external femoral fixation techniques often causes complications of knee flexion dysfunction. We report on technical modifications in the complications of external femoral fixation leading to knee flexion disorders.Methods: We flexed the knee joint 90 degrees during the operation, and then placed the external fixation nail. A retrospective review was performed for all patients undergoing repair by this technique. Results: A total of 52 children with femoral shaft fractures were included, the flexion of the knee joint measured at the time of discharge was 80 degrees (70-90 degrees) on average; when the external fixation is removed, the knee flexion can reach an average of 95 degrees (90-115 degrees), no children have stiff knees.Conclusion: This technique is simple and easy to implement, and it is worthy of popularization and application in clinical practice.
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