Application of Kirschner wire placement guided technology in paediatric supracondylar humerus fractures.

BACKGROUND: To analyze the clinical efficacy of K-wire placement guided technology in paediatric supracondylar humerus fractures. METHODS: A retrospective study was conducted in 105 patients who underwent closed reduction and percutaneous pinning surgeries in our hospital from June 2019 to August 2022. 54 patients treated with a assisted reduction fixation device to assist in closed reduction and percutaneous K-wire cross-fixation were allocated into the Non-guided group, and 51 patients with K-wire placement guided technology to guide K-wire placement were assigned into the Guided group. The operation duration, number of disposable K-wire placement, intraoperative fluoroscopy frequency, Baumann angle, carrying angle, fracture healing time and Flynn score of elbow joint function at the final follow-up were compared between two groups. The postoperative complications of two groups were recorded. RESULTS: There were significant differences between two groups in terms of operation duration, intraoperative fluoroscopy frequency, and disposable K-wire placement rate (p < 0. 05), while no significant differences of Baumann angle, carrying angle and the fracture healing time between two groups were observed (p > 0. 05). In the control group, ulnar nerve injury in 2 case, pin site infection in 4 cases, mild cubitus varus in 2 cases and loss of reduction in 4 cases were detected. In the study group, ulnar nerve injury in 1 case, pin site infection in 2 cases and loss of reduction in 1 case was observed. There was no significant difference in Flynn scores between two groups. CONCLUSION: K-wire placement guided technology is simple and convenient. The application of K-wire placement guided technology could relatively improved disposable K-wire placement rate, shorten the intraoperative fluoroscopy frequencies and reduce complication rates.

[Selection of suitable procedure in the treatment of degenerative lumbar scoliosis based upon imaging studies].

OBJECTIVE: To compare the clinical efficacies of two different procedures in the treatment of degenerative lumbar scoliosis. METHODS: From August 2008 to August 2011, 28 patients of lumbar degenerative scoliosis were divided into one group (n = 14) undergoing modified transforaminal lumbar interbody fusion (TLIF) instrumented surgery and another group (n = 14) undergoing posterolateral fusion (PLF) instrumented surgery. There were 12 males and 16 females with a mean age of 66.2 years (range: 54-79). The operative durations and bleeding volumes of two groups were recorded. The post-operative efficacy was evaluated with VAS (visual analogue scale) for low back pain, ODI (Oswestry disability index), Cobb' angle and lumbar lordosis angle on plain film. RESULTS: The mean follow-up period was 25.9 months. The operative duration was 192.0 ± 44.7 min in modified TLIF group versus 163.0 ± 39.0 min in PLF group. The bleeding volume was 718.0 ± 197.2 ml in modified TLIF group versus 546.0 ± 226.6 ml in PLF group. All operated lumbar intervertebral achieved bony fusion in modified TLIF group by the last follow-up. Two cases had no bony fusion and there was one case of pseudarthrosis in PLF group. Significant differences existed between two groups in pre-operative and post-operative values of VAS, ODI, Cobb' s angle and lumbar lordosis angle (P < 0.05). There were significant differences between two groups in the values of pre-operative and post-operative VAS and lumbar lordosis angle (P < 0.05) but not in the values of pre-operative and post-operative ODI and Cobb' s angle (P > 0.05). CONCLUSION: As an alternative, safe and effective procedure, modified TLIF instrumented is superior to PLF instrumented in the treatment of lumbar degenerative scoliosis.