A Foead1, R Penafort, A Saw, S Sengupta. 1. Department of Orthopaedic Surgery, University Malaya Medical Center, 50603 Kuala Lumpur, Malaysia.
Abstract
PURPOSE: To conduct a prospective randomised controlled study to compare the stability and risk of nerve injury between fractures treated by medial-lateral pin fixation and those treated by 2-lateral pin fixation. METHODS:Patients with displaced supracondylar fractures admitted between May 2000 and December 2001 were recruited into the study. They were randomised to treatment either with medial-lateral pin fixation (n=34) or with 2-lateral pin fixation (n=32). RESULTS:66 children with the mean age of 5.78 years were admitted during the study period. 11 of them were lost to follow-up. The mean follow-up period of the remaining 55 patients was 8.93 months. The difference in the carrying angle between injured and normal elbows was 3.57 degrees and 3.70 degrees in medial-lateral pin fixation and 2-lateral pin fixation, respectively. The extension and flexion loss was 7.14 degrees and 8.68 degrees respectively in medial-lateral pin fixation, and 7.11 degrees and 11.26 degrees respectively in 2-lateral pin fixation. The Baumann angle difference was 5.96 degrees in medial-lateral pin fixation, and 5.30 degrees in 2-lateral pin fixation. The difference in the medial epicondylar epiphyseal angle was 6.07 degrees in medial-lateral pin fixation and 6.92 degrees in 2-lateral pin fixation. Statistical analyses show that these differences are not significant. Five iatrogenic ulnar nerve injuries developed in the group treated by medial-lateral pin fixation, while 2 ulnar nerve and one radial nerve injuries were seen after 2-lateral pin fixation. Again the differences were not statistically significant. CONCLUSION: Both methods of fixation were comparable in terms of stability, duration of bone healing, and risks of injury to the nerve.
RCT Entities:
PURPOSE: To conduct a prospective randomised controlled study to compare the stability and risk of nerve injury between fractures treated by medial-lateral pin fixation and those treated by 2-lateral pin fixation. METHODS:Patients with displaced supracondylar fractures admitted between May 2000 and December 2001 were recruited into the study. They were randomised to treatment either with medial-lateral pin fixation (n=34) or with 2-lateral pin fixation (n=32). RESULTS: 66 children with the mean age of 5.78 years were admitted during the study period. 11 of them were lost to follow-up. The mean follow-up period of the remaining 55 patients was 8.93 months. The difference in the carrying angle between injured and normal elbows was 3.57 degrees and 3.70 degrees in medial-lateral pin fixation and 2-lateral pin fixation, respectively. The extension and flexion loss was 7.14 degrees and 8.68 degrees respectively in medial-lateral pin fixation, and 7.11 degrees and 11.26 degrees respectively in 2-lateral pin fixation. The Baumann angle difference was 5.96 degrees in medial-lateral pin fixation, and 5.30 degrees in 2-lateral pin fixation. The difference in the medial epicondylar epiphyseal angle was 6.07 degrees in medial-lateral pin fixation and 6.92 degrees in 2-lateral pin fixation. Statistical analyses show that these differences are not significant. Five iatrogenic ulnar nerve injuries developed in the group treated by medial-lateral pin fixation, while 2 ulnar nerve and one radial nerve injuries were seen after 2-lateral pin fixation. Again the differences were not statistically significant. CONCLUSION: Both methods of fixation were comparable in terms of stability, duration of bone healing, and risks of injury to the nerve.
Authors: Ben A Marson; Adeel Ikram; Simon Craxford; Sharon R Lewis; Kathryn R Price; Benjamin J Ollivere Journal: Cochrane Database Syst Rev Date: 2022-06-09
Authors: Juan Pretell-Mazzini; Juan Rodriguez-Martin; Ismael Auñon-Martin; José Alberto Zafra-Jimenez Journal: Strategies Trauma Limb Reconstr Date: 2011-07-22