Clinical Study Of Treatment Of Irreducible Humeral Supracondylar Fracture In Children With Anterior Elbow Small Incision

Objective : Introducing Operation method and curative effect of irreducible humeral supracondylar fracture in children with anterior elbow small incision.Methods:There are 114 patients of irreducible humeral supracondylar fracture in children with anterior elbow small incision which all have been followed up from 2007.4 to 2014.4. 95 of the patients are male, and the others are female. The mean age of the patients is 5.7(range from 2 to 13) years. All the patients have received the operation treatment among 4h to 48 h after injury. which are all closed Gartland type III fractures, 76 cases on the left side,38 cases on the right side; including 16 cases of comminuted fracture, 16 cases of epiphyseal fracture, 7 cases with median nerve injury, 2 cases complicated with radial nerve injury, 3 cases combined with brachial artery injury.From the anterior elbow small incision,we can expose broken ends of fractured bone. After positioning,using 1 titanium needle for cross fixation at the humerus internal and external condyle respectively, the patients can begin to do functional exercise postoperative 3 weeks.Collect after1 week, 3 weeks, 1 month and 6 months of elbow joint and lateral X-ray,according to criteria such as Flynn to assess healing of the fracture,carrying angle and elbow flexion.Results:Group on the humerus supracondyle fracture(n=114) have been followed up ranging form 2 months to 2 years.,114 patients with fractures were all healed well.The anteversion and carrying angle were satisfied,Elbow joint activities freely,No elbow varus deformity. There were 7 patients with median nerve injury,2 cases complicated with radial nerve injury.Carried out the nerve exploration and repair through this incision,the nerve function were recovered perfectly after 2 months.3 cases with brachial artery injuried.1 case of vascular anastomosis bas been completed, and 2 cases of vascular adventitial loose solution through this incision bave been completed.Finally, the vascular after operation have been unobstructed. According to the evaluation of Flynn standard:excellent effect were obtained in 97 patients whose elbow joint has no pain.The carrying angle and elbow flexion extension function loss of 0 ~ 5°; good level: 11 cases.The carrying angle and elbow flexion extension function loss of 6~10°;general level: 6 cases,Elbow flexion and extension is limited within 15°,The carrying angle loss of less than 10°.In this group, the excellent-and-good rate was 94.7%.3 cases of children occurred with titanium pin loosening in the follow-up period, but it did not affect fracture healing.Conclusion:The method, selecting anterior elbow small incision to open reduction and cross titanium needle fixation to treat children humerus supracondyle fracture has shown that it has somany advantages,such as good disclose, reset easy, simple operation and good recovery of joint function.