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Comparison of posterior approach with lateral approach for late or neglected lateral condylar humeral fracture in children
摘要
Introduction: The treatment of late or neglected lateral condylar humeral fracture in children has been reported with controversy; however, no study has directly compared patient outcomes of the lateral and posterior approaches to repair in this population. Our objective was to conduct such a study in children using time delay as a comparative measure. Materials and Methods: This was a retrospective cohort study in which we reviewed records for neglected lateral condylar humeral fracture in children treated with open reduction via lateral or posterior approach. The analysis included 12 cases from a 10-year period in our medical center, from 1993 to 2003. Perioperative and follow-up data were reviewed. This data was used to create 2 groups, with each patient in the lateral approach matched according to time delay to a corresponding patient in the posterior approach group. Results: Six patients from each cohort were successfully time matched (lateral approach vs. posterior approach). The postoperative elbow range of motion was limited in the lateral approach group, compared with near full range of motion in the posterior approach group. Physeal changes were more severe in the lateral approach group. The carrying angle difference, when compared with the opposite normal elbow, was greater in the lateral approach group. Complications were observed in all patients, with deformities in greater numbers and with greater severity observed in the lateral approach group. Conclusions: In our time-match comparison, the posterior approach resulted in better functional and gross outcome due to better articular cartilage congruity, as well as fewer complications.
延伸閱讀
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