Relevant Efficacy Comparison Of Kinds Of Different Methods In The Treatment Of Neglected Fracture Of Lateral Condyle Of Humerus Within 12 Weeks

Objective:The fracture of lateral condyle of humerus refers to the intra-articular fracture of lateral condyle of humerus with humeral head or partial pulley,which is the most common epiphyseal injury of elbow joint.Because it belongs to intra-articular injury,the unossified cartilage can not be developed under ordinary X-ray,so it is easy to be misdiagnosed at the first diagnosis,resulting in fracture malunion.It is generally believed that when the treatment of a fracture is delayed for more than 3 weeks,it is clinically called neglected fracture.At present,scholars at home and abroad unanimously recommend open reduction and internal fixation for this kind of fracture treatment,but there are still differences in the choice of internal fixation types.The commonly used internal fixation in clinic includes Kirschner wire,hollow compression screw and absorbable screw.The purpose of this study was to compare the clinical effects of Kirschner wire and hollow nail internal fixation in the treatment of neglected fracture of lateral condyle of humerus in children.Methods:A total of 81 children with neglected fracture of lateral condyle of humerus treated with hollow nail and Kirschner wire in our hospital from January 2016 to March 2020 were collected and sorted out.According to the choice of internal fixation,they were divided into Kirschner wire group(n = 48)and hollow nail group(n = 33).The differences of age,injury to operation time,postoperative carrying angle and Baumann angle between the two groups were analyzed by two independent samples T-test,and the differences in gender,affected side and fracture injury type(Jakobe type)between the two groups were analyzed by Chi-square test.The function of elbow joint was evaluated by Dhillon score at the last follow-up.Postoperative complications were evaluated by incision infection,relaxation of nail path,limitation of joint flexion and extension,avascular necrosis and delayed healing.Results:There was no significant difference in age,sex,affected side,operation time,injury to operation time and fracture classification between Kirschner wire group and hollow nail group(P > 0.05).There was no significant difference in Baumann angle(15.71 °±2.95 °)and carrying angle(5.71 °±3.03 °)between Kirschner wire group and hollow nail group(16.16 °±3.13 °)and 5.32 °±3.08 °(P > 0.05).The Dhillon score of elbow joint in Kirschner wire group and hollow nail group were 6～10(8.23±1.41)and6～10(8.58±1.28)respectively,and there was no significant difference.There were no complications such as cubitus valgus deformity,fishtail deformity and avascular necrosis in both groups.However,among the short-term complications,there were 1case of nail path infection,1 case of nail path relaxation and 1 case of limitation of joint flexion and extension in the Kirschner needle group,2 cases of nail path infection,5 cases of limitation of joint flexion and extension and 1 case of delayed healing in the hollow nail group.The incidence of complications in the hollow nail group(24.24%)was significantly higher than that in the Kirschner needle group(6.67%)(P= 0.046).Conclusions:Both Kirschner wire internal fixation and hollow nail combined with Kirschner wire internal fixation can achieve satisfactory results in the treatment of neglected fracture of lateral condyle of humerus in children.However,Kirschner wire internal fixation has a lower incidence of postoperative Short-term complications than hollow nail internal fixation and requires no second operation,so it can be used as a preferred choice.