The necessity of ulnar nerve exploration and translocation in open reduction of medial humeral epicondyle fractures in children

作者全名：Liu, S.; Su, Y.

作者地址：[Liu, S.; Su, Y.] Chongqing Med Univ, Childrens Hosp, Orthoped Dept, Chongqing, Peoples R China; [Liu, S.; Su, Y.] Chongqing Key Lab Pediat, Chongqing, Peoples R China; [Liu, S.; Su, Y.] Minist Educ, Key Lab Child Dev & Disorders, Chongqing, Peoples R China; [Liu, S.; Su, Y.] Natl Clin Res Ctr Child Hlth & Disorders, Chongqing, Peoples R China; [Liu, S.; Su, Y.] China Int Sci & Technol Cooperat Base Child Dev &, Chongqing, Peoples R China; [Liu, S.; Su, Y.] Chongqing Med Univ, Jiangxi Hosp, Affiliated Childrens Hosp, Nanchang, Peoples R China

通信作者：Su, Y (通讯作者)，Chongqing Med Univ, Childrens Hosp, Orthoped Dept, Chongqing, Peoples R China.; Su, Y (通讯作者)，Minist Educ, Key Lab Child Dev & Disorders, Chongqing, Peoples R China.; Su, Y (通讯作者)，Natl Clin Res Ctr Child Hlth & Disorders, Chongqing, Peoples R China.; Su, Y (通讯作者)，China Int Sci & Technol Cooperat Base Child Dev &, Chongqing, Peoples R China.; Su, Y (通讯作者)，Chongqing Med Univ, Jiangxi Hosp, Affiliated Childrens Hosp, Nanchang, Peoples R China.

来源：BONE & JOINT JOURNAL

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001198874400015

JCR分区：Q1

影响因子：4.9

年份：2024

卷号：106B

期号：2

开始页：212

结束页：218

文献类型：Article

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摘要：Aims Medial humeral epicondyle fractures (MHEFs) are common elbow fractures in children. Open reduction should be performed in patients with MHEF who have entrapped intraarticular fragments as well as displacement. However, following open reduction, transposition of the ulnar nerve is disputed. The aim of this study is to evaluate the need for ulnar nerve exploration and transposition. Methods This was a retrospective cohort study. The clinical data of patients who underwent surgical treatment of MHEF in our hospital from January 2015 to January 2022 were collected. The patients were allocated to either transposition or non- transposition groups. Data for sex, age, cause of fracture, duration of follow - up, Papavasiliou and Crawford classification, injury - to- surgery time, preoperative ulnar nerve symptoms, intraoperative exploration of ulnar nerve injury, surgical incision length, intraoperative blood loss, postoperative ulnar nerve symptoms, complications, persistent ulnar neuropathy, and elbow joint function were analyzed. Binary logistic regression analysis was used for statistical analysis. Results A total of 124 patients were followed up, 50 in the ulnar nerve transposition group and 74 in the non- transposition group. There were significant differences in ulnar nerve injury (p = 0.009), incision length (p < 0.001), and blood loss (p = 0.003) between the two groups. Binary logistic regression analysis revealed that preoperative ulnar nerve symptoms (p = 0.012) were risk factors for postoperative ulnar nerve symptoms. In addition, ulnar nerve transposition did not affect the occurrence of postoperative ulnar nerve symptoms (p = 0.468). Conclusion Ulnar nerve transposition did not improve clinical outcomes. It is recommended that the ulnar nerve should not be transposed when treating MHEF operatively.

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