OBJECTIVE The aim of this study was to evaluate the outcomes of pediatric patients who were treated for olecranon and displaced radial neck fractures with absorbable rods and Kirschner wires. METHODS Thirty-one patients (20 male, 11 female), aged from 3 to 13 years old with olecranon and displaced radial neck fractures treated with absorbable rods and Kirschner wires, were included in this retrospective, single-center study. All radial neck fractures were Judet type IV, and there were 17 type C and 14 type D olecranon fractures. The follow-up time ranged from 26 to 56 months (average 35.8 months). The Boyd approach was used first to reduce olecranon fractures and fix them with Kirschner wires. Thereafter, radial neck fractures were reduced and fixed with absorbable rods. Patients' functional outcomes were assessed using the Mayo Elbow Performance Index score. RESULTS Results were excellent in 19 patients, good in 8 patients, fair in 2 patients, and poor in 2 cases according to the Mayo Elbow Performance Index score. The rate of excellent and good outcomes was 87.1%. The average Mayo Elbow Performance Index score was 91.5 points. Three patients showed radial nerve injuries preoperatively, which were assessed intraoperatively. No nerve repair was required, and all nerve injuries recovered within 3 months. CONCLUSION This study has shown us that using a Boyd approach for open reduction and fixation with absorbable rods and K-wires is feasible for olecranon and severely displaced radial neck fractures in pediatric patients. LEVEL OF EVIDENCE Level IV, Therapeutic study.

Background To summarize and analyze the epidemiological characteristics, treatment and corresponding curative effect of triradiate cartilage injury(TCI) in children after trauma, to provide a theoretical basis for early diagnosis and improvement of treatment. Methods The TCI was classified according to Bucholz classification, and the final curative effect was evaluated with Harris Hip Score and imaging examination during follow-up. Finally, a comprehensive analysis was made by reviewing the cases in the literature combined with the patients in our hospital. Results A total of 15 cases (18 hips) of triradiate cartilage injuries were collected in our hospital. There was 1 hip with type I injury, nine hips with type II injury, two hips with type IV injury, one hip with type V injury and five hips with type VI injury. Among the 12 cases with complete follow-up, the bone bridge was found in or around the triradiate cartilage in 8 cases, early fusion of triradiate cartilage occurred in 5 patients, 3 cases had hip dysplasia, 4 cases had a subluxation of the femoral head, and HHS was excellent in 8 cases and good in 4 cases. Conclusion The early diagnosis of TCI is still a difficult problem. Conservative treatment is often the first choice. The overall prognosis of acetabular fractures involving triradiate cartilage is poor. The formation of the bone bridge in triradiate cartilage usually indicates the possibility of premature closure, which may lead to severe complications of post-traumatic acetabular dysplasia and subluxation of the femoral head.

目的 探讨跨关节外固定架治疗儿童胫骨远端骨折的临床疗效.方法 选取重庆医科大学附属儿童医院2010年1月至2016年12月于门诊手法复位失败的胫骨远端闭合性骨折患者49例为研究对象,其中男34例,女15例,年龄8.5～16.2岁,平均12.3岁.右踝骨折39例,左踝骨折10例.手术在C型臂X光机监视下进行,行踝关节轴向牵引,根据骨折类型对患者足部进行内旋或外旋,达到解剖复位后行跨关节外固定架固定,远端螺钉固定于距骨颈与跟骨,近端固定于胫骨近端.如骨折断端嵌有软组织阻碍复位或牵引复位不成功,则行切开复位.术中行X线检查,确定骨折是否解剖复位,骨折间隙<2 mm为复位成功.术后无需石膏固定,术后1周开始下床负重,术后3周活动踝关节,并采用AOFAS评分系统评估整体疗效.结果 49例中,闭合复位成功30例,有限切开复位固定19例.随访12～90个月,平均38个月.末次X线片检查提示49例均骨性愈合,未发现关节面不平整现象,无踝关节内外翻和短缩畸形,术后5～8周拆除外固定架.AOFAS评分系统判定结果:优39例,良9例,一般1例.患者均能正常参加体育活动.结论 跨关节外固定架治疗儿童胫骨远端骨折整体疗效满意,能有效恢复踝关节关节面的平整,避免踝关节僵硬,是治疗儿童胫骨骨折的可选方法之一.

Background: The application of external femoral fixation techniques often causes complications of knee flexion dysfunction. We report on technical modifications in the complications of external femoral fixation leading to knee flexion disorders. Methods: We flexed the knee joint 90 degrees during the operation, and then placed the external fixation nail. A retrospective review was performed for all patients undergoing repair by this technique. Results: A total of 52 children with femoral shaft fractures were included, the flexion of the knee joint measured at the time of discharge was 80 degrees (70-90 degrees) on average; when the external fixation is removed, the knee flexion can reach an average of 95 degrees (90-115 degrees), no children have stiff knees. Conclusion: This technique is simple and easy to implement, and it is worthy of popularization and application in clinical practice.