Ulrasonography guided Closed Reduction in the Treatment of Displaced Transphyseal Fracture of the Distal Humerus
Abstract Background: To evaluate the clinical and radiographic outcomes after ulrasonography guided Closed reduction in the treatment of displaced transphyseal fracture of the distal Humerus (TFDH).Methods: Twenty-seven patients with displaced TFDH successfully treated by the ulrasonography guided closed reduction during January 2012 to December 2016 were retrospective reviewed. After mean follow-up of 34.88 months, the clinical and radiographic outcomes of patients were evaluated. The cubitus varus of the affected elbow were also assessed at latest follow-up.Results: The successful rate of ultrasonography guided closed reduction in the treatment of displaced TFDH was 84% (27/32). The twenty-seven patients with successful reduction were included for the following analysis. There were 20 male patients and 7 female patients included the study and the mean age at treatment was 15.39±3.10 months, seventeen fractures occurred in right side elbow and ten in left side. At the last follow-up, there were significant decreases in the elbow flexion (3°, P=0.027) and range of motion (5°, P=0.003) between the injured and uninjured elbow, respectively. Whereas no difference in elbow extension was detected (P=0.110). Flynn’s criteria assessment showed that all the patients achieved excellent or good outcomes both in the functional and cosmetic categories. The clinical and radiographic carrying angle at the last follow-up were 11.67 ± 3.11° and 10.46 ± 3.88°, respectively. And the incidence of cubitus varus after treament was 7.4% at last follow-up.Conclusion: The ultrasonography guided closed reduction in the treatment of displaced TFDH is an effective procedure, the adequate fracture reduction can be acquired with the advantages of real-time, non-radioactive, and simple utilization. With the percutaneous pining fixation, satisfactory clinical and radiographic outcomes can be achieved with low incidence of postoperative cubitus varus.