Clinical study of emergency treatment and selective closed reduction for the treatment of supracondylar humerus fracture in children

摘要

Objective: To study the effect of emergency treatment, selective closed reduction combined with percutaneous Kirschner wire fixation on the treatment of Gartland type-II and type-III supracondylar humerus fracture. Methods: Children who sustained the Gartland type-II and type-III supracondylar fractures of humerus treated with selective closed reduction combined with percutaneous Kirschner wire fixation in our hospital from May 2012 to August 2015 were analyzed retrospectively. They were divided into group A (emergency operation group) and group B (selective operation group) according to different operation timing. Perioperative sit-uation, blood biochemical parameters, swelling degree and elbow joint function of affected limb were compared between two groups. Results: Operation time for patients of group A was significantly shorter than that of group B [(17.19 ± 2.85) vs. (21.43 ± 3.91) min], and frequency of fluoroscopy during operation of group A was obviously less than that of group B [(6.03 ± 0.95) vs. (7.61 ± 0.92) times]. Swelling index of affected limb in group A at 3 days, 5 days and 7 days after injury was all significantly lower than that in group B [(1.20 ± 0.17) vs. (1.38 ± 0.14), (1.13 ± 0.13) vs. (1.30 ± 0.18), (1.02 ± 0.15) vs. (1.22 ± 0.15)]. Hospital for special surgery score at 1 week, 2 weeks, 3 and 4 weeks after removing Kirschner wire had no significant difference between group A and B (88.75 ± 10.18) vs. (89.14 ± 10.52), (94.22 ± 10.85) vs. (93.85 ± 11.08), (95.52 ± 11.27) vs. (95.92 ± 12.19), (95.43 ± 10.96) vs. (96.02 ± 11.38). Contents of serum alanine transaminase, aspertate aminotransferase, total protein, albumin and C-reactive protein in perioperative period had no obvious difference between patients in group A and B. Conclusions: Emergency closed reduction combined with percutaneous Kirschner wire fixation for Gartland type-II and type-III supracondylar humerus fracture in children has less trauma, low swelling degree of affected limb in perioperative period, and good effect on the recovery of the elbow joint function after operation.