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Kirschner wire versus external fixation in the treatment of proximal humeral fractures in older children and adolescents: a comparative study

OBJECTIVE: The purpose of this study was to compare the therapeutic effects of Kirschner wire fixation and external fixation in the treatment of proximal humeral fractures in older children and adolescents. METHODS: A retrospective analysis was performed on the clinical data of older children and ad...

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Autores principales: Wang, Yu, Wang, Qian, Yao, Wuyi, Zhao, Jingxin, Zhao, Xiaobin, He, Man
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10656960/
https://www.ncbi.nlm.nih.gov/pubmed/37980527
http://dx.doi.org/10.1186/s12891-023-07037-x
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author Wang, Yu
Wang, Qian
Yao, Wuyi
Zhao, Jingxin
Zhao, Xiaobin
He, Man
author_facet Wang, Yu
Wang, Qian
Yao, Wuyi
Zhao, Jingxin
Zhao, Xiaobin
He, Man
author_sort Wang, Yu
collection PubMed
description OBJECTIVE: The purpose of this study was to compare the therapeutic effects of Kirschner wire fixation and external fixation in the treatment of proximal humeral fractures in older children and adolescents. METHODS: A retrospective analysis was performed on the clinical data of older children and adolescents who underwent surgery at our institution for proximal humeral fractures between April 2014 and May 2022. One group (n = 28) underwent fracture reduction and Kirschner wire fixation, and the other group (n = 23) underwent external fixation. During the follow-up, the differences in shoulder joint function between the two groups were compared by analysing Quick Disabilities of the Arm, Shoulder, and Hand (Quick DASH) and Constant-Murley scores. Postoperative complications were also recorded. RESULTS: The operation time of the Kirschner wire group was shorter than that of the external fixation group (69.07 ± 11.34 min vs. 77.39 ± 15.74 min, P = 0.33). The time to remove the fixator in the external fixation group was shorter than that in the Kirschner wire group (6.74 ± 1.57 vs. 7.61 ± 1.22, P = 0.032). The Quick DASH score and Constant-Murley score of the patients in the external fixation group were significantly better than those in the Kirschner wire group at 3 months after surgery (5.63 ± 4.33 vs. 8.93 ± 6.40, P = 0.040; 93.78 ± 2.43 vs. 91.75 ± 2.15, P = 0.003). There was no significant difference in the Quick DASH score or Constant-Murley score between the patients in the external fixator group and those in the Kirschner wire group at 9 months after the operation (2.77 ± 3.14 vs. 3.17 ± 3.68, P = 0.683; 97.39 ± 1.80 vs. 96.57 ± 2.15, P = 0.152). The most common complication of the two groups was pin tract infection. The incidence rate of infection was higher in the external fixation group than that in the Kirschner wire group (9 vs. 4, P = 0.043). CONCLUSION: Both Kirschner wire fixation and external fixation of N-H III and IV proximal humeral fractures in older children and adolescents produce good outcomes. External fixation is a preferred surgical treatment option for paediatric proximal humerus fractures because early mobilization of the affected limb can be realized. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12891-023-07037-x.
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spelling pubmed-106569602023-11-18 Kirschner wire versus external fixation in the treatment of proximal humeral fractures in older children and adolescents: a comparative study Wang, Yu Wang, Qian Yao, Wuyi Zhao, Jingxin Zhao, Xiaobin He, Man BMC Musculoskelet Disord Research OBJECTIVE: The purpose of this study was to compare the therapeutic effects of Kirschner wire fixation and external fixation in the treatment of proximal humeral fractures in older children and adolescents. METHODS: A retrospective analysis was performed on the clinical data of older children and adolescents who underwent surgery at our institution for proximal humeral fractures between April 2014 and May 2022. One group (n = 28) underwent fracture reduction and Kirschner wire fixation, and the other group (n = 23) underwent external fixation. During the follow-up, the differences in shoulder joint function between the two groups were compared by analysing Quick Disabilities of the Arm, Shoulder, and Hand (Quick DASH) and Constant-Murley scores. Postoperative complications were also recorded. RESULTS: The operation time of the Kirschner wire group was shorter than that of the external fixation group (69.07 ± 11.34 min vs. 77.39 ± 15.74 min, P = 0.33). The time to remove the fixator in the external fixation group was shorter than that in the Kirschner wire group (6.74 ± 1.57 vs. 7.61 ± 1.22, P = 0.032). The Quick DASH score and Constant-Murley score of the patients in the external fixation group were significantly better than those in the Kirschner wire group at 3 months after surgery (5.63 ± 4.33 vs. 8.93 ± 6.40, P = 0.040; 93.78 ± 2.43 vs. 91.75 ± 2.15, P = 0.003). There was no significant difference in the Quick DASH score or Constant-Murley score between the patients in the external fixator group and those in the Kirschner wire group at 9 months after the operation (2.77 ± 3.14 vs. 3.17 ± 3.68, P = 0.683; 97.39 ± 1.80 vs. 96.57 ± 2.15, P = 0.152). The most common complication of the two groups was pin tract infection. The incidence rate of infection was higher in the external fixation group than that in the Kirschner wire group (9 vs. 4, P = 0.043). CONCLUSION: Both Kirschner wire fixation and external fixation of N-H III and IV proximal humeral fractures in older children and adolescents produce good outcomes. External fixation is a preferred surgical treatment option for paediatric proximal humerus fractures because early mobilization of the affected limb can be realized. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12891-023-07037-x. BioMed Central 2023-11-18 /pmc/articles/PMC10656960/ /pubmed/37980527 http://dx.doi.org/10.1186/s12891-023-07037-x Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Wang, Yu
Wang, Qian
Yao, Wuyi
Zhao, Jingxin
Zhao, Xiaobin
He, Man
Kirschner wire versus external fixation in the treatment of proximal humeral fractures in older children and adolescents: a comparative study
title Kirschner wire versus external fixation in the treatment of proximal humeral fractures in older children and adolescents: a comparative study
title_full Kirschner wire versus external fixation in the treatment of proximal humeral fractures in older children and adolescents: a comparative study
title_fullStr Kirschner wire versus external fixation in the treatment of proximal humeral fractures in older children and adolescents: a comparative study
title_full_unstemmed Kirschner wire versus external fixation in the treatment of proximal humeral fractures in older children and adolescents: a comparative study
title_short Kirschner wire versus external fixation in the treatment of proximal humeral fractures in older children and adolescents: a comparative study
title_sort kirschner wire versus external fixation in the treatment of proximal humeral fractures in older children and adolescents: a comparative study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10656960/
https://www.ncbi.nlm.nih.gov/pubmed/37980527
http://dx.doi.org/10.1186/s12891-023-07037-x
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