| Objective To explore the clinical effects of manual reduction and percutaneous pin fixation versus open reduction and kirschner wire internal fixation in the treatment of displaced>2mm Jakob type Ⅱ humeral lateral condyle fractures.Methods A prospective randomized controlled study was used to randomly divide 60 patients with lateral condyle humerus fractures who met the inclusion criteria from the Pediatric Orthopedics Department of the Second Hospital of Fuzhou from December 2018 to December 2019 into 30 cases in the experimental group and 30 cases in the control group.In the experimental group,manual reduction and percutaneous pin fixation were used for treatment,and the control group was treated with open reduction and kirschner wire internal fixation.The clinical data of the two groups of patients were systematically collected according to the inpatient cases.Observation and comparison of the clinical healing time of fractures,postoperative infection rate,operation time and surgical bleeding volume between the two groups after treatment and changes in the incidence of complications and Dhillon elbow function score of 6 months after operation.Results All patients were followed up and no cases fell off in clinical studies.The average age was 4.8 years(3-12 years),including 46 males and 14 females;there were 38 cases on the left and 22 cases on the right.The initial degree of fracture displacement was 2.1-4.9mm,with an average of 3.5mm.There was no significant difference in clinical healing time(42.83 ± 3.37 days VS 44.27 ± 3.66 days)and postoperative infection rate(3.33% VS 0%)between the experimental group and the control group,P>0.05.Two cases of avascular necrosis and one case of premature epiphyseal closure were found in the control group,and no related complications were found in the experimental group.There was no statistically significant difference in the incidence of complication between two groups(10% VS 0%)after 6 months of surgery,P>0.05.The Dhillon score at 6 months postoperatively indicated that the excellent rate of the experimental group was 96.67%,19 cases were excellent,10 cases were good,1 case was fair,0 cases were poor,and the control group was 100% excellent,22 cases were excellent,8 cases were good,0 cases were fair,and 0 cases were poor.There was no significant difference between the two groups,P>0.05.There was no significant difference in pain symptom score(2.93 ± 0.25 points VS 2.97 ± 0.18 points),range of motion score(2.77 ± 0.43 points VS 2.87 ± 0.35 points),carrying angle score(2.80 ± 0.41 points VS 2.90 ± 0.31 points),and Dhillon’s score(8.50 ± 0.78 points VS 8.73 ±0.45 points)between the experimental group and the control group,P>0.05.As for the difference in surgical time and intraoperative blood loss between the two groups,there was a statistically significant difference,P<0.05.Compared with the control group,the experimental group had shorter surgical time(27.17 ± 11.50 min VS 45.33 ± 10.82min)and less bleeding(2.63 ± 1.13 ml VS 26.07 ± 7.27ml).Conclusion Manual reduction and percutaneous pin fixation compared with open reduction and internal fixation for the treatment of Jakob type Ⅱ humeral lateral condyle fractureswith a displacement of >2 mm has the advantages of shorter operation time and less trauma,and is worthy of further clinical promotion. |
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