Risk factors analysis of residual displacement after Kirschner wire internal fixation for unstable humeral supracondylar fracture in children

MA Xu-bin; LI Jun-ke; LI Liang

doi:10.11659/jjssx.06E024013

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Risk factors analysis of residual displacement after Kirschner wire internal fixation for unstable humeral supracondylar fracture in children

Clinical Research | 更新时间：2025-09-24

- Risk factors analysis of residual displacement after Kirschner wire internal fixation for unstable humeral supracondylar fracture in children
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 34, Issue 9, Pages: 822-826(2025)
- 作者机构：
  
  邯郸市第一医院骨科，河北邯郸 056000
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.06E024013
  CLC： R274.1
- Received：04 June 2024，
  
  Published：25 September 2025
- 稿件说明：
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马续彬,李军科,李亮.儿童不稳定型肱骨髁上骨折克氏针内固定术后残留移位的风险因素分析[J].局解手术学杂志,2025,34(09):822-826.

MA Xu-bin,LI Jun-ke,LI Liang.Risk factors analysis of residual displacement after Kirschner wire internal fixation for unstable humeral supracondylar fracture in children[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(09):822-826.
马续彬,李军科,李亮.儿童不稳定型肱骨髁上骨折克氏针内固定术后残留移位的风险因素分析[J].局解手术学杂志,2025,34(09):822-826. DOI： 10.11659/jjssx.06E024013.

MA Xu-bin,LI Jun-ke,LI Liang.Risk factors analysis of residual displacement after Kirschner wire internal fixation for unstable humeral supracondylar fracture in children[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(09):822-826. DOI： 10.11659/jjssx.06E024013.

摘要

目的

探究儿童不稳定型肱骨髁上骨折克氏针内固定术后残留移位的风险因素。

方法

选取2019年3月至2023年10月因肱骨髁上骨折于我院行克氏针内固定术的128例患者，按康复后肱骨髁上移位程度将患者分为：正常组（

=63）、Ⅰ级组（

=29）、Ⅱ级组（

=22）、Ⅲ级组（

=14）。对各组患者的手术前后力学参数及一般资料进行比较；建立

LASSO

回归模型，筛选导致残留移位的影响因素；采用多因素

Logistic

回归分析Ⅲ级患者术后残留移位的风险因素；构建术后残留移位的风险因素模型，并对模型进行评价。

结果

经克氏针内固定术治疗后，患者的肱骨髁上力学参数较术前明显改善（

0.05）。各组患者间的骨折愈合时间、骨折固定时间、Gartland分型、复位方式、术后并发症、Flynn评分、肱骨小头前倾角、Baumann角、提携角和肱骨远端扭转角比较，差异具有统计学意义（

0.05）。

LASSO

回归模型显示，骨折愈合时间、Gartland分型、术后并发症、Baumann角、肱骨远端扭转角和Flynn评分为出现残留移位的相关指标；

Logistic

回归分析显示，骨折愈合时间≥50 min、Gartland分型Ⅲ型、出现术后并发症和Flynn评分为可或差是导致Ⅲ级患者术后残留移位的独立危险因素；受试者工作特征（

ROC

）曲线显示，该风险因素模型具有良好的区分能力[（曲线下面积(

AUC

)为0.858，95%

：0.823~0.897）

]

。

结论

克氏针内固定术治疗肱骨髁上骨折疗效明显，可以显著改善患者的肱骨髁上力学参数；骨折愈合时间≥50 min、Gartland分型Ⅲ型、出现术后并发症和Flynn评分为可或差是肱骨髁上骨折患者克氏针内固定术后残留移位的风险因素。

Abstract

Objective

To explore the risk factors of residual displacement after Kirschner wire internal fixation for unstable humeral supracondylar fracture in children.

Methods

A total of 128 children who underwent Kirschner wire internal fixation for humeral supracondylar fracture in our hospital from March 2019 to October 2023 were selected.According to the degree of humeral supracondylar displacement after recovery， the patients were divided into the normal group （

=63）， grade Ⅰ group （

=29）， grade Ⅱ group （

=22） and grade Ⅲgroup （

=14）.The mechanical parameters before and after the operation and general data of patients in each group were compared.A

LASSO

regression model was established to screen the influen

cing factors of residual displacement.Multivariate

Logistic

regression analysis was used to analyze the risk factors of postoperative residual displacement in patients with grade Ⅲ.A risk factor model of postoperative residual displacement was constructed and evaluated.

Results

After treatment with Kirschner wire internal fixation， the humeral supracondylar mechanical parameters of the patients significantly improved compared to those before operation （

0.05）. There were statistically significant differences among the groups in terms of fracture healing time， fracture fixation time， Gartland classification， reduction method， postoperative complications， Flynn score， anterior inclination angle of the humeral head， Baumann angle， carrying angle， and distal humeral torsion angle （

0.05）.The

LASSO

regression model indicated that fracture healing time， Gartland classification， postoperative complications， Baumann angle， distal humeral torsion angle， and Flynn score were the relevant indicators of residual displacement.The

Logistic

regression analysis revealed that fracture healing time≥50 minutes， Gartland classification of grade Ⅲ， occurrence of postoperative complications， and Flynn score （average or poor） were independent risk factors for residual displacement after surgery in patients with grade Ⅲ.The

receiver operating characteristic

（

ROC

） curve showed that this risk factor model had good discrimination ability ［

area under the curve

（

AUC

）=0.858， 95%

： 0.823 to 0.897］.

Conclusion

The internal fixation with Kirschner wire for treatment of humeral supracondylar fracture has a remarkable therapeutic effect， and it can significantly improve the humeral supracondylar mechanical parameters of the patients.The fracture healing time≥50 minutes， Gartland classification of grade Ⅲ， occurrence of postoperative complications， and Flynn score （average or poor） are risk factors for residual displacement after internal fixation with Kirschner wire in patients with humeral supracondylar fracture.

关键词

Keywords

references

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