Delaying Surgery in Type III Supracondylar Humerus Fractures Does Not Lead to Longer Surgical Times or More Difficult Reduction.J Orthop Trauma. 2019 Aug;33(8):e285-e290 AbstractOBJECTIVE:To determine if delay in surgical treatment of type III supracondylar humerus fracture would affect the length of operative time. DESIGN:Retrospective cohort study. SETTING:Level 1 trauma center. PATIENTS/PARTICIPANTS:This is a series of 309 modified改良 Gartland type III supracondylar fractures treated operatively from 2011 to 2013. INTERVENTION:Fifteen hours was defined as the cutoff between early and delayed treatment. A total of 53.7% (166/309) fractures were treated early, and 46.4% (143/309) were delayed. MAIN OUTCOME MEASUREMENTS:Surgical time was defined as "incision start" to "incision close." Fluoroscopy time透视时间 was used as a surrogate代替 for difficulty of reduction. RESULTS:Time from injury to operating room was shorter for high-energy fractures (fractures with soft-tissue or neurovascular injury) versus low-energy fractures (12.9 vs. 15.3 hours, P < 0.0001); however, surgical time (37.3 vs. 31.8 minutes, P = 0.004) and fluoroscopy time (54.6 vs. 48.6 seconds, P = 0.027) were longer in high-energy fractures versus low-energy fractures. Among low-energy fractures, no significant difference was detected in the surgical time between the early and delayed treatment groups or in the fluoroscopy time. In addition, there was no statistically significant difference found in the surgical or fluoroscopy time with the presence of a surgical assistant. CONCLUSIONS:Delay in surgery did not result in a longer surgical time or more difficult reduction for type III supracondylar humerus fracture. Patients with low-energy fractures still underwent a shorter operative time even with delay from injury to surgery. 百度翻译： 摘要 目标：探讨肱骨髁上Ⅲ型骨折延迟手术治疗对手术时间的影响。 设计：回顾性队列研究。 设置：一级创伤中心。 患者/参与者：这是一系列309例改良GartlandⅢ型髁上骨折的手术治疗，从2011年到2013年。 干预：15小时被定义为早期治疗和延迟治疗之间的界限。骨折早期治疗率为53.7%（166/309），延迟治疗率为46.4%（143/309）。 主要结果测量：手术时间定义为从“切口开始”到“切口闭合”，透视时间作为复位困难的替代。 结果：高能骨折（伴有软组织或神经血管损伤的骨折）与低能骨折（12.9与15.3小时，P<0.0001）相比，从损伤到手术室的时间更短；然而，手术时间（37.3与31.8分钟，P=0.004）和透视时间（54.6与48.6秒，在高能骨折中P=0.027）比在低能骨折中更长。在低能量骨折中，早期和延迟治疗组的手术时间和透视时间均无显著性差异。此外，在有手术助手在场的情况下，手术或透视时间没有统计学上的显著差异。 结论：对于III型肱骨髁上骨折，手术延迟并没有导致手术时间延长或复位困难。低能量骨折患者即使从损伤到手术延迟，手术时间仍较短。 |
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