مقايسه نتايج درماني شكستگي هاي سوپراكنديلار بازوي كودكان به دو روش جراحي با رويكرد خارجي و خلفي

Therapeutic Results of Supracondylar Fractures of Children's Arms Using Lateral and Posterior Approach

سابقه و هدف: شكستگي‌هاي سوپراكونديلار استخوان بـازو در كودكـان شـايع بوده و شيوه‌هاي جراحي مختلفي براي آن وجود دارد. اين مطالعه، بمنظور مقايسه نتايج درماني به روش جراحي باز با رويكرد خارجي و خلفي انجام شد. مواد و روش‌ها: اين مطالعه مقطعي بر روي200 كودك مبتلا به شكستگي‌سوپراكنديلار بازو با سن كم‌تر از10 سال،كه طي سال‌هاي 97-1393 به بيمارستان شهيد ‌بهشتي بابل مراجعه و تحت عمل جراحي به روش خارجي و خلفي قرار گرفتند، انجام شد. اطلاعات شامل سن، جنس، علت شكستگي، نوع شكستگي، سمت شكستگي، دامنه حركت مفصل آرنج در هفته هشتم بعد از عمل و بررسي راديوگرافي، در دو گروه مقايسه شد. يافته‌ها: از 200 كودك، 98 نفر (48/8 درصد) تحت جراحي با رويكرد خارجي و 102 نفر (51/2 درصد) با رويكرد خلفي قرار داشتند. سن، جنس، سمت درگيري و غالب بودن دست درگير بين دو روش، تفاوت معني‌داري نداشت (0/05

Background and purpose: Supracondylar fracture of the humerus is common in children and various surgical procedures are used to manage this condition. This study was conducted to compare the treatment results of open surgical approaches; external (lateral) and posterior access. Materials and methods: This cross-sectional study was performed in 200 children (younger than 10 years of age) with supracondylar fractures of the arm attending Babol Shahid Beheshti Hospital (2014-2018) who underwent open surgery using either lateral or posterior approach. Radiographic examination and some factors such as age, sex, cause of fracture, type of fracture, fracture side, and range of motion of elbow joint were compared between the two groups at week eight after the surgeries. Results: Among the patients, 98 (48.8%) underwent surgery with lateral approach and 102 (51.2%) underwent posterior approach. There were no significant differences between the two groups in age, sex, fracture side, and the predominance of the involved arm (P<0.05). We observed no significant differences between the range of motion, bearing angle, flexion and extension of the injured side. Clinical and radiological variables in injured and healthy hands in the external approach showed that range of motion (152.45±3.27 vs. 143.61±4.50), carrying angle (11.98±1.72 vs. 11.44±2.75), and flexion (141.91±3.30 vs. 134.35±4.85) and extension (10.60±1.69 vs. 9±2.35) of the elbow were lower in the injured hand (P<0.001). In comparing the clinical and radiological variables between the injured and healthy hand in the posterior approach, it was found that the range of motion (152.78±3.64 vs. 144.39±4.39), carrying angle (12.4±1.47 vs. 11.62±1.83), and flexion (142.54±3.33 vs. 135.41±4.36) and extension (10.14±1.81 vs. 8.89±2.07) of the elbow were lower in the injured hand (P<0.001). Conclusion: The study showed no significant differences between external and posterior approaches in treatment of supracondylar fractures of the arm.