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Objective:To investigate the clinical effect of minimally invasive treatment of supracondylar fracture of humerus with nerve injury and the need for surgical exploration of nerve.Methods:From August 2017 to September 2020, 34 cases of children with supracondylar fracture of humerus with nerve injury in the Department of orthopedics of Shanxi Children′s Hospital were selected for retrospective analysis.Closed reduction, Kirschner wire fixation and small incision surgery were used to explore the injured nerve.The follow-up period ranged from 6 months to 3 years, with a follow-up time of (2.15±0.49) years.The elbow function, radial nerve, median nerve and ulnar nerve function were evaluated according to the trial standard of upper limb peripheral nerve function evaluation of Hand Surgery Society of Chinese Medical Association.Results:The elbow function of children in this group: excellent 31 cases, good 2 cases, fair 1 cases, poor 0 cases, excellent 33 cases.Three patients failed to take early functional rehabilitation exercise.Two patients recovered after 2.5 months of treatment by professional orthopedic rehabilitation therapists and physical therapy.One of them did not cooperate with functional rehabilitation training.After 3.5 months of treatment by orthopedic rehabilitation therapists, elbow and finger functions were not affected.Two weeks after nerve injury: radial nerve function evaluation: excellent in 15 cases, good in 3 cases, fair in 4 cases, poor in 0 cases, excellent in 18 cases.Median nerve function evaluation: excellent in 5 cases, good in 2 cases, fair in 6 cases, poor in 0 cases, excellent in 7 cases.Ulnar nerve function evaluation: excellent 5 cases, good 0 cases, fair 1 cases, poor 0 cases, excellent 5 cases.At 3 months after injury, the excellent and good rate of radial nerve, median nerve and ulnar nerve was 100%.Conclusion:The supracondylar fracture of humerus with nerve injury is treated by minimally invasive surgery, and the nerve exploration is still a few.The recovery of nerve injury after surgery is smooth, and the clinical effect is good.
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Introduction: Supracondylar fractures of Humerus are one of the most common fractures in pediatric age group. The aim ofthe study was to evaluate the functional results in the management of supracondylar fracture of humerus in children by variousmethods.Materials and Methods: This study was conducted at the Orthopaedics department of Mahatma Gandhi MemorialHospital, Warangal. This was a 2 years prospective, longitudinal, hospital based, observational study and its outcomes.Participants were a total of 30 children aged 0 to 14 years (21 males, 9 females) diagnosed with supracondylar fractureof humerus.Results: Patients were assessed by Flynn’s criteria. Results were excellent in 70%, good in 20%, fair in 6.66%, and poor in 3.33%.Conclusion: Closed reduction and external immobilization are reserved for Gartland’s type 1 and select type 2 fractures. Inunstable type 2 and type 3, closed or open reduction and K-wire fixation give better results.
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Objective To investigate the closed replacement via internal and external crossed fixation with three kirschner wires on treating supracondylar fracture of humerus in children.Methods One hundred and six patients with supracondylar fracture of humerus in Osteopathic Hospital of Nanyang City from June 2010 to July 2015were divided into control group and observation group.Fifty patients in the control group were given closed replacement via external crossed fixation with three kirschner wires,while fifty-six patients in the observation were given closed replacement via internal and external crossed fixation with three kirschner wires.The visual analogue scales(VAS) score was recorded in the two groups before and after treatment.The curative effect was evaluated by Flynn elbow function evaluation standard and the incidence of postoperative complication was compared between the two groups.Results All the patients were followed up for 3-24 months.The time of fracture healing in the control group and the observation group was (6.0 ± 1.0) weeks and (5.6 ± 1.0) weeks respectively,there was no significant difference in the time of fracture healing between the two groups(P ＞0.05).There was no significant difference in the VAS score before treatment in the two groups (P ＞ 0.05).After treatment the VAS score in the two groups was lower than that before treatment(P ＜ 0.05),and the VAS score in the observation group was lower than that in the control group (P ＜0.05).The therapeutic efficiency in the control group and the observation group was 74.00％ (37/50) and 91.07％(51/56),respectively.The therapeutic efficiency in the observation group was higher than that in the control group(x2 =5.461,P ＜ 0.05).The incidence of postoperative complication in the control group and the observation group was 16.00％ (8/50) and 3.57％ (2/56),respectively.The incidence of postoperative complication in the observation group was lower than that in the control group (x2 =4.624,P ＜ 0.05).Conclusion Comparing with the treatment of closed replacement via external crossed fixation with three kirschner wires,therapeutic efficiency of the closed replacement via internal and external crossed fixation with three kirschner wires in treating children supracondylar fracture of humerus is more obviously and the incidence of postoperative complication is lower.
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Objective To compare the clinical effects on Gartland type Ⅲ fractures in children by open reduction and external fixation with two parallel Kirschner wires and closed reduction.Methods From February 2013 to October 2016,84 children with Gartland type Ⅲ supracondylar fracture of humerus were selected and randomly divided into a control group and an observation group,each with a total of 42 cases.The control group received closed reduction treatment,and the observation group received open and external fixation with two parallel Kirschner wires.The two groups were compared on intraoperative blood loss,incision length,operating time,decreased degrees of carrying angle,reduced flexion-extension at the fractured side and the rates for good and excellent clinical effects.Results The observation group behaved significantly better than the control group in intraoperative blood loss,incision length and operating time (P＜0.05).The rates for good and excellent effects was 90.47％ in the observation group and 73.81％ in the control group,and there was obvious difference between the values in the two groups (P＜0.05).The observation group had the decreased degree of carrying angle statistically lower than that in the control group (P＜0.05),while the reduced flexion-extension at the fractured side was not significantly different from that in the control group (P＞0.05).Conclusion Open reduction and external fixation with two parallel Kirschner wires and closed reduction both gain their advantages when used to treat Gartland type llⅢ fractures in children,the former has high clinical effect,significantly recovered elbow joint function and low incidence rate for cubitus varus,and the latter has slight invasion,small incision while relatively low clinical effect and high incidence rate for cubitus varus.
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Objective To analyze the effect of traditional Chinese combined with Western medicine on the treatment of supracondylar fracture of humerus, and provide reference for clinical treatment.Methods122 patients with supracondylar fracture of humerus in hospital the affiliated hospital of traditional Chinese and western medicine;Zhejiang Chinese Medicine University from January 2015 to March 2016 were randomly divided into the observation group and the control group.The control group were given conventional fracture reduction, the observation group were given a new therapy of integrated traditional and western.Treatment outcome, quality of life changes and prognosis in the two groups were compared.ResultsThe excellent rate in the observation group (91.8%) was significantly higher than that in the control group (72.1%) (P<0.05).The fracture healing time in the observation group (4.1±1.1)months was significantly shorter than that in the control group (6.6±2.3) months (P<0.05).Before treatment, there was no significant difference in quality of life scores between the two groups;after treatment the overall health in the observation group (75.69±4.61), physiological function (77.62±4.19), pain (74.63±4.96), social function (76.84±4.28), mental health (76.12±4.18) scores were significantly higher than those overall health(62.74±4.36) in the control group, physiological function (64.51±4.12), pain (67.26±4.25), social function(68.72±4.13), mental health (65.97±4.23) (P<0.05).There were 2 cases with cubitus varus in the observation group, while 3 cases with elbow inversion in the control group.All patients were followed up for more than 6 months.There was no serious infection and abnormal bone development in the two groups.ConclusionIt can improve the treatment effect, reduce the pain of patients, promote the rapid recovery of the disease, improve the quality of life and prognosis, which traditional Chinese medicine combined with Western medicine was used in the treatment of humeral supracondylar fracture, it has the value of use.
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Objective To compare the clinical effects on Gartland type Ⅲ fractures in children by open reduction and external fixation with two parallel Kirschner wires and closed reduction.Methods From February 2013 to October 2016,84 children with Gartland type Ⅲ supracondylar fracture of humerus were selected and randomly divided into a control group and an observation group,each with a total of 42 cases.The control group received closed reduction treatment,and the observation group received open and external fixation with two parallel Kirschner wires.The two groups were compared on intraoperative blood loss,incision length,operating time,decreased degrees of carrying angle,reduced flexion-extension at the fractured side and the rates for good and excellent clinical effects.Results The observation group behaved significantly better than the control group in intraoperative blood loss,incision length and operating time (P＜0.05).The rates for good and excellent effects was 90.47％ in the observation group and 73.81％ in the control group,and there was obvious difference between the values in the two groups (P＜0.05).The observation group had the decreased degree of carrying angle statistically lower than that in the control group (P＜0.05),while the reduced flexion-extension at the fractured side was not significantly different from that in the control group (P＞0.05).Conclusion Open reduction and external fixation with two parallel Kirschner wires and closed reduction both gain their advantages when used to treat Gartland type llⅢ fractures in children,the former has high clinical effect,significantly recovered elbow joint function and low incidence rate for cubitus varus,and the latter has slight invasion,small incision while relatively low clinical effect and high incidence rate for cubitus varus.
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Objective To investigate clinical results of bilateral triceps bradhii approach in Gartland Ⅲ supracondylar fracture of humerus in children by comparing with reduction interne and plaster immobilization. Methods 102 children with Gartland Ⅲ supracondylar fracture of humerus,4 ～ 13 years old,from May 2003 to May 2009,were randomly divided into operation group and control group,51 cases separately. The operation group was treated by bilateral triceps bradhii approach, while control group was treated by reduction interne and plaster immobilization. All patients were made function exercise 4 weeks later,X-ray check periodically and followed up about 16 months with angle patronner and elbow joint function recorded. According to Flynn clinical function criteria,all patients were classified and analyzed. Results After follow-up and elbow joint function evaluation,48 cases ( 94. 1% ) show excellent and good results,3 cases(5.9% ) fair and poor in operation group,32 cases(62. 7% ) and 19 cases(37. 3% ) in control group. The differences between two groups was statistically singnificant ( P < 0. 05). Conclusion Comparing with reduction interne and plaster immobilization, bilateral triceps bradhii approach in Gartland Ⅲ supracondylar fracture of humerus in children has good clinical results and may be more effective therapy.
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Objective To investigate the effect of psychological nursing in children with supracondylar fracture of humerus undergoing open reduction and internal fuxation. Methods 63 children with supracondylar fracture of humerus undergoing open reduction and internal fixation were randomly divided into the control group (30 cases) and the observation group (33 cases), the control group were given routine nursing care, the observation group received psychological intervention in addition to the routine nursing care, the nursing effect of two groups were compared. Results In the observation group, the excellent and good rate was 97.0%, significantly higher than 80.0% of the control group, the incidence of complications of the observation group was 6.1%, slightly lower than 10.0% of the control group, there was no significant difference between two groups; the children (or) family members,satisfaction degree nursing staff in the observation group was 97.0%, significantly higher than 76.7% of the control group, the difference between the two groups was statistically significant. Conclusions Psychological nursing based upon routine nursing in children with supracondylar fracture of humerus undergoing open reduction and internal fixation proved satisfactory clinical results, and conducive to the rehabilitation of patients, so it is worth popularizing.
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【Objective】External fixation for supracondylar fracture of humerus is improved for the effective prevention of cubitus varus.【Methods】Sixty-eight patients with severe displaced supracondylar fracture of humerus was fixed by medial-lateral splint and elastic rubber ring,with elbow fixed in flexion and supination and near the chest by plaster support.【Results】 The results of follow-up showed that 68 patients were clinically cured,and the rate of cubitus varus was 2.9%,which was lower than that by other methods reported in domestic literatures.【Conclusion】This kind of fixation has the advantages of fixing the fracture firmly,keeping good para-position,preventing rotation displacement,counteracting gravitation-induced ulnar deviation and reducing the occurrence of cubitus varus.
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Supracondylar fracture of the humerus is the most common fracture of the elbow in children For period of 4 years from Jan. 1980 to Dec. 1983, 54 children with dispaced supracondylar fracture of the humerus were classified by direction of displacement of distal fragment and treated by immediate closed reduction after lateral skeletal traction. 32 cases of these were followed up for more than 6 months. The results were obtained as follows.: 1) The most common incidence (79.6%) was 5 to 12 years of age and male and female ratio was 2.4 : l. The left humerus was involved in 35 cases (64.8%). 2) Of all fracture, extension type was 96.3% and flexion type 3.7%. 3) Under the exact anteroposteier and lateral views, fractures were classified by displaced direction of distal fragment. Immediate closed reduction was done by using thick and strong periosteal hinge after lateral skeletal traction. The more accurate anatomical reduction was obtained by maintenance of reduction state and further correction during lateral skeletal traction, and complications such as VIC, loss of reduction were lessened probably. 4) For follow up study of 32 cases, final result were analized according to Mitchells classification. Excellent results were obtained 23 cases (71.9%) Good results were 8 cases (25.0%) Unsatisfactory result was 1 case (3.1 %) 5) In 2 cases of treatment failure, the brachialis muscle was buttonholed by metaphyseal spike of the proximal fragment. 6) During lateral skeletal traction, superficial infection was developed through pin tract in 4 cases. These were treated by the administration of antibiotics and there were no complication such as osteomyelitis.