A Clinical Study Of Single Posterior Support Splint Fixation To Prevent Children With Straight Humeral Supracondylar Fractures Complicated With Early Cubitus Varus

Objective: In order to reduce the incidence of early cubitus varus in children with extended supracondylar humeral fractures treated with single back bracket splint fixation,Baumann angle was introduced as an early warning index to evaluate the occurrence of early cubitus varus.In the early stage of fracture healing,manual reduction was used to adjust the angle of Baumann angle of affected limbs,so as to control and prevent early cubitus varus.To provide early warning indicators for prevention of humeral supracondylar fracture complicated with early cubitus varus by external fixation with single posterior bracket splint.Methods: A total of 66 cases of humeral supracondylar fracture were collected and divided into two groups by random number table.33 cases in the treatment group and 33 cases in the control group were treated with manual reduction and Baumann angle was measured as the early intervention standard.The treatment group and the control group were treated withsingle back bracket splint fixation and traditional four-in-one splint fixation respectively.The Baumann angle before and after reduction,one week after reduction and three months after reduction were measured,and the change of Baumann angle in each stage of fracture healing was compared between the two groups.The loss values of Baumann angle and the angle of lifting angle in the two groups were compared with those in the healthy side,and the correlation between the two angles was analyzed by statistical analysis.Differences in elbow function and incidence of complications.Result: There was significant difference in Baumann angle before and after internal reduction in each group by paired t-test,but no significant difference was found between the two groups at different time levels,such as before and after reduction,1 week and 3 months.There was significant difference in angle loss between the treatment group and the control group within 3 months after reduction(P < 0.05),and the Baumann angle loss value in the treatment group was less than that in the control group.They were 5.60+5.42 and 8.24+6.86 degrees,respectively.The Baumann angle at 1 week after reduction was significantly correlated with the lift angle at 3 months after reduction.Pearson correlation coefficients were-0.680 and-0.710,respectively.The incidence of cubitus varus in treatment group and control group was 12.1% and 15.1%,respectively.The excellent and good rates of Flynn’s cubitus varus criteria in two groups were 72.7% and 69.6%,and the excellent and good rates of elbow joint function in two groups were 87.8% and 84.8%,respectively.The incidence of tension blisters was 6.06%,30.3% and Volkmann ischemic muscle contracture was 3.03% and 15.1% in the two groups.CONCLUSION: Statistical data demonstrate the mechanical stability of single back bracket splint again;single back bracket splint fixation has the same practical effect as traditional four-in-one splint in preventing early cubitus varus and restoring elbow joint function;the study demonstrates the negative correlation between Baumann angle and lifting angle again,and the maintenance of Baumann angle in the early stage of supracondylar fracture of humerus is to prevent the intraelbow angle.Necessary conditions for turning over deformity.The single posterior bracket splint fixation after maintaining Baumann angle in the early stage of fracture is of preventive significance for children with extended supracondylar fracture of humerus complicated with early cubitus varus deformity.