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Comparison the treatment between lateral pins and medial and lateral (crossed) pins for fixation of displaced supracondylar fractures of humerus in children after closed reduction

مقارنة بين العلاج بالأسياخ من الجهة الوحشية و الأسياخ من الجهتين ( المتقاطعة ) لتثبيت كسور فوق لقمتي العضد المتبدلة عند الأطفال بعد الرد المغلق لها

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 Publication date 2016
and research's language is العربية
 Created by Shamra Editor




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Closed reduction and percutaneous pin fixation is considered standard management for displaced supracondylar fractures of the humerus in children. However, controversy exists regarding whether to use pins from the lateral side or medial and lateral side of the elbow for fixation . We performed this research to know the results of two ways of treatment and to compare : 1- the risk of iatrogenic ulnar nerve injury caused by pin fixation . 2- quality of fracture reduction in terms of radiographic outcomes . 3- compare function of the elbow and other surgical complications caused by pin fixation between two ways.


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Research summary
تتناول هذه الدراسة مقارنة بين طريقتين لتثبيت كسور فوق لقمتي العضد المتبدلة عند الأطفال باستخدام أسياخ كيرشنر عبر الجلد بعد الرد المغلق. الطريقة الأولى تعتمد على تثبيت الأسياخ من الجهة الوحشية فقط، بينما الطريقة الثانية تستخدم الأسياخ من الجهتين الأنسية والوحشية (المتقاطعة). شملت الدراسة 100 طفل تتراوح أعمارهم بين 3 و13 عامًا، وتمت متابعتهم لمدة 6 أشهر. هدفت الدراسة إلى مقارنة خطر أذية العصب الزندي، جودة الرد الشعاعي، والوظيفة والاختلاطات الجراحية بين الطريقتين. أظهرت النتائج عدم وجود اختلاف إحصائي مهم في النتائج الشعاعية أو الوظيفية أو الاختلاطات الجراحية الأخرى بين الطريقتين. ومع ذلك، تبين أن استخدام الأسياخ المتقاطعة يزيد من خطر أذية العصب الزندي. بناءً على هذه النتائج، توصي الدراسة باستخدام طريقة الأسياخ الوحشية لتثبيت كسور فوق لقمتي العضد عند الأطفال لتقليل خطر أذية العصب الزندي.
Critical review
دراسة نقدية: على الرغم من أن الدراسة تقدم مقارنة شاملة بين الطريقتين وتستند إلى بيانات إحصائية دقيقة، إلا أن هناك بعض النقاط التي يمكن تحسينها. أولاً، كان من المفيد تضمين مجموعة تحكم لمقارنة النتائج بشكل أفضل. ثانيًا، لم يتم التطرق إلى العوامل النفسية والاجتماعية التي قد تؤثر على تعافي الأطفال، مثل الدعم الأسري والمجتمعي. ثالثًا، يمكن أن تكون فترة المتابعة لمدة 6 أشهر غير كافية لتقييم النتائج الطويلة الأمد والتأكد من عدم حدوث مضاعفات مستقبلية. وأخيرًا، كان من الممكن أن تكون الدراسة أكثر شمولية إذا تم تضمين عدد أكبر من الأطفال من مختلف المناطق الجغرافية لتعميم النتائج بشكل أفضل.
Questions related to the research
  1. ما هي الطريقتان المستخدمتان في تثبيت كسور فوق لقمتي العضد المتبدلة عند الأطفال؟

    الطريقة الأولى تعتمد على تثبيت الأسياخ من الجهة الوحشية فقط، بينما الطريقة الثانية تستخدم الأسياخ من الجهتين الأنسية والوحشية (المتقاطعة).

  2. ما هو الهدف الرئيسي من هذه الدراسة؟

    الهدف الرئيسي هو مقارنة خطر أذية العصب الزندي، جودة الرد الشعاعي، والوظيفة والاختلاطات الجراحية بين الطريقتين.

  3. ما هي النتائج الرئيسية التي توصلت إليها الدراسة؟

    أظهرت الدراسة عدم وجود اختلاف إحصائي مهم في النتائج الشعاعية أو الوظيفية أو الاختلاطات الجراحية الأخرى بين الطريقتين، ولكن استخدام الأسياخ المتقاطعة يزيد من خطر أذية العصب الزندي.

  4. ما هي التوصيات التي قدمتها الدراسة بناءً على النتائج؟

    توصي الدراسة باستخدام طريقة الأسياخ الوحشية لتثبيت كسور فوق لقمتي العضد عند الأطفال لتقليل خطر أذية العصب الزندي.


References used
ABRAHAM E, GORDON A, ABDUL-HADI O,2005-: Management of supracondylar fractures of humerus with condylar involvement in children. J Pediatr Orthop, New York, 3. 75-101
AITKEN AP , SMITH L , BLACKETT CW,2007- Supracondylar fractures in children. Am J Surg, Northern Ireland, 5.27-35
ALBURGER PD,WEIDNER PL,1992- Supracondylar fractures of the humerus in children. J Pediatr Orthop, North Carolina, 6.103- 151
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