Comparative study on emergency treatment and selective closed reduction and percutaneous pin fixation for hu-meral supracondylar fracture of Gartland typeⅡand typeⅢin children / 中华实用儿科临床杂志

ABSTRACT

Objective To investigate the curative efficacy of fracture with closed reduction and percutaneous Kirschner wire fixation of the simple lateral injury for humeral supracondylar fracture of Gartland type Ⅱ and type Ⅲ in children by the emergency treatment and selective surgery. Methods From March 2010 to March 2012,sixty children with Gartland type Ⅱ and type Ⅲ fresh humeral supracondylar fracture were operated in Xianyang Center Hospital. Six-ty children were randomly divided into two groupsgroup A by emergency operation 8 hours after injury with closed re-duction method and lateral percutaneous Kirschner wire fixation only,group B initially treated with plast fixation,then undergoing surgery after 3 - 5 days of injury with the closed reduction and percutaneous pin fixation. The operation du-ration,frequency of intraoperative image intensifier,postoperative swelling,pain lasting time after injury and hospitaliza-tion cost were investigated in two groups. Results The average operation duration of group A was(18. 5 ± 12. 3)min, and that in group B was(20. 1 ± 15. 3)min,and there was a statistically significant difference between two groups(P ﹤0. 05). The frequency of intraoperative image intensifier was 6. 2 times on the average in group A,but 7. 3 times in group B,and there was a statistically significant difference between two groups(P ﹤ 0. 05). The postoperative swelling rate on 3,5,7 days after injury in group B was significantly higher than that of group A,and there was a statistically sig-nificant difference(all P ﹤ 0. 05). The duration of pain after injury in group A was(3. 44 ± 1. 23)days,but(5. 26 ± 1. 36)days in group B,which was significantly different;the nerve function recovery time of group A was(36. 5 ± 7. 0) d,and it was(36. 2 ± 7. 0)d in group B,which was not significantly different(P ﹥ 0. 05). The average hospitalization time and cost in group A was less than that in group B,which was significantly different(P ﹤ 0. 05). Finally there was no statistically significant difference in elbow joint function between two groups of children(P ﹥ 0. 05). Conclusions The emergency operation of closed reduction and percutaneous Kirschner wire fixation for the treatment of simple lateral injury in children with Gartland type Ⅱ and type Ⅲ fracture has the advantages over the selective surgery,including shorter operation time,less contact of X - ray intraoperatively,light postoperative swelling,short duration of pain in chil-dren,as well as the shortened hospitalization time,reduced costs,especially good efficacy for joint function recovery.