Risk factors of cubitus varus in extension type supracondylar humeral fracture in children
Cao Bing1,2, Sun Xiangshui1
1Department of Orthopaedics, Children's Hospital of Nanjing Medical University, Nanjing 210008, China; 2Nanjing Medical University the Fourth School of Clinical Medicine, Nanjing 211166, China
Abstract:Objective This study aimed to investigate the risk factors of cubit varus deformity after treatment of txtension type supracondylar humeral fracture in children. Methods This was a retrospective case control study. Clinical data of 630 children with txtension type humeral supracondylar fracture admitted at the Department of Orthopedic Surgery, Children's Hospital of Nanjing Medical University, from September 2017 to August 2020 were included in this study, including 458 males and 172 females aged 1-14 (8.4±2.7) years. Among them, 35 were cubital varus cases and 595 were non-cubital varus cases. For outcome measures: (1) Univariate analysis of risk factors for cubitus varus deformity (include gender, age, body mass index, Gartland type of fracture, direction of distal fracture displacement, whether combined with rotational displacement, treatment method, and time from fracture to functional exercise) was conducted. (2) Multivariate logistic regression model was used to analyze the independent risk factors for cubital varus deformity. Results Univariate analysis showed that the direction of fracture displacement was a risk factor for cubital varus (χ2=73.13, P<0.001). Further multivariate logistic regression analysis showed that ulnar deviation was an independent risk factor for cubital varus (odds ratio: 19.54, 95% confidence interval: 5.748-66.423, P<0.001). Conclusion Distal ulnar deviation is an independent risk factor for cubitus varus in children with txtension type supracondylar humeral fracture.
曹秉, 孙祥水. 儿童伸直型肱骨髁上骨折治疗后肘内翻畸形的危险因素分析[J]. 中华解剖与临床杂志, 2022, 27(11): 769-772.
Cao Bing, Sun Xiangshui. Risk factors of cubitus varus in extension type supracondylar humeral fracture in children. Chinese Journal of Anatomy and Clinics, 2022, 27(11): 769-772.
Ali AM, Abouelnas BA, Elgohary HS.Dome osteotomy using the paratricipital (triceps-sparing) approach for cubitus varus deformity in children: a surgical technique to avoid lateral condylar prominence[J]. J Pediatr Orthop B, 2016,25(1):62-68. DOI: 10.1097/BPB.0000000000000205
Canales-Zamora OA, Mora-Ríos FG, Mejía-Rohenes LC, et al.Complications of supracondylar humeral fractures in children[J]. Acta Ortop Mex, 2020,34(2):91-95
[4]
Wan W, Wu W, Li G, et al.A modified rotating isosceles triangle osteotomy using a 3D-printed patient-specific guide for the treatment of cubitus varus in children: a case report and literature review[J]. Transl Pediatr, 2021,10(1):215-222. DOI: 10.21037/tp-20-101
[5]
Vashisht S, Sudesh P, Gopinathan NR, et al.Results of the modified reverse step-cut osteotomy in paediatric cubitus varus[J]. Int Orthop, 2020,44(7):1417-1426. DOI: 10.1007/s00264-020-04648-0
[6]
Verka PS, Kejariwal U, Singh B. Management of cubitus varus deformity in children by closed dome osteotomy[J]. J Clin Diagn Res, 2017,11(3):RC08-RC12. DOI: 10.7860/JCDR/2017/24345.9551
[7]
Jha RK, Thapa S, Singh D.Outcome of corrective dome osteotomy for cubitus varus deformity[J]. Journal of Nobel Medical College, 2019, 8(2):42-46. DOI:10.3126/jonmc. v8i2.26760
[8]
Kasirajan S, Govindasamy R, Lokayah SK.Functional outcome of modified French osteotomy fixed with recon-locking compression plate in older children[J]. J Clin Orthop Trauma, 2021,16:202-207. DOI: 10.1016/j.jcot.2021.01.008
[9]
Karatosun V, Alekberov C, Alici E, et al.Treatment of cubitus varus using the Ilizarov technique of distraction osteogenesis[J]. J Bone Joint Surg Br, 2000,82(7):1030-1033. DOI: 10.1302/0301-620x.82b7.10669
[10]
郭跃明, 王志远, 邹勇根, 等. 肱骨髁上骨折并发肘内翻畸形病理形态学分析[J].中国矫形外科杂志,2004,12(10):725-727. DOI: 10.3969/j.issn.1005-84.8.2004.10.001.Guo YM, Wang ZY, Zou YG, et al.Pathomorphism analysis of cubitus varus following superacondylar fractures of the humerus[J]. Orthopedic Journal of China, 2004,12(10):725-727. DOI: 10.3969/j.issn.1005-84.8.2004.10.001
[11]
吕建敏,林传甫,兰丽琴.儿童肱骨髁上骨折保守治疗后发生肘内翻的危险因素分析[J].中国骨伤,2017,30(5):431-435. DOI:10.369/j.issn.1003-0034.2017.05.008.Lyu JM, Lin CF, Lan LQ.Risk factors of cubitus varus in humeral condylar fracture after conservative treatment in child[J]. China J Orthop Trauma,2017,30(5):431-435. DOI: 10.369/j.issn.1003-0034.2017.05.008
[12]
Bauer AS, Pham B, Lattanza LL.Surgical correction of cubitus varus[J]. J Hand Surg Am,2016,41(3):447-452. DOI: 10.1016/j.jhsa.2015.12.019
[13]
Solfelt DA, Hill BW, Anderson CP, et al. Supracondylar osteotomy for the treatment of cubitus varus in children: a systematic review[J]. Bone Joint J, 2014,96-B(5):691-700. DOI: 10.1302/0301-620X.96B5.32296
[14]
Cha SM, Shin HD, Ahn JS.Relationship of cubitus varus and ulnar varus deformity in supracondylar humeral fractures according to the age at injury[J]. J Shoulder Elbow Surg, 2016,25(2):289-296. DOI: 10.1016/j.jse.2015.10.014
[15]
Çabuk H, Dedeoğlu SS, Adaş M, et al.Medial spike and obesity associate with open reduction in type Ⅲ supracondylar humeral fracture[J]. Acta Chir Orthop Traumatol Cech, 2016,83(2):102-105
[16]
张天久, 俞松, 杨小红. 儿童肱骨髁上骨折致肘内翻形成原因的探讨[J]. 中国骨与关节杂志,2015,4(6):473-476.DOI: 10.3969/j.issn.2095-252X.2015.06.011.Zhang TJ, Yu S, Yang XH.A discussion on the causes of children distal humerus fractures leading to cubitus varus[J]. Chinese Journal of Bone and Joint,2015,4(6):473-476. DOI: 10.3969/j.issn.2095-252X.2015.06.011
[17]
Moreira R, Nishimi AY, Zanon EM, et al.Cross-sectional study of Gartland Ⅱ and Ⅲ humerus supracondylar fracture treatment in childhood: Brazilian orthopedists' opinion[J]. Rev Bras Ortop, 2018, 53(2):129-135.DOI:10.1016/j.rboe.2017.02.007
[18]
Ducić S, Bumbasirević M, Radlović V, et al.Displaced supracondylar humeral fractures in children: comparison of three treatment approaches[J]. Srp Arh Celok Lek, 2016,144(1-2):46-51. DOI: 10.2298/sarh1602046d
[19]
Durusoy S, Öner K, Özer A, et al.The effect of the angle between fracture line and Kirschner wires on stability in supracondylar humerus fractures treated with Kirschner wire fixation: a finite element analysis[J]. Jt Dis Relat Surg, 2021,32(1):75-84. DOI: 10.5606/ehc.2021.77279
[20]
Leonidou A, Chettiar K, Graham S, et al.Open reduction internal fixation of lateral humeral condyle fractures in children. A series of 105 fractures from a single institution[J]. Strategies Trauma Limb Reconstr, 2014,9(2):73-78. DOI: 10.1007/s11751-014-0193-z.