| Purpose:To compare the clinical efficacy and prognosis of olecranon traction and Kirschner wire internal fixation in the treatment of Gartland III supracondylar fracture of humerus in childrenMethod: Clinical case data of children diagnosed with Gartland III supracondylar fracture of humerus and hospitalized with surgical treatment meeting the inclusion and exclusion criteria were retrospectively collected from Shenzhen Children’s Hospital from January 2013 to June 2019.The data included gender,age,time from admission to operation,length of stay,hospitalization cost,radiological measurement data,and follow-up evaluation of efficacy.The X-ray taken in outpatient or hospital preparation was used as post-injury X-ray measurement to evaluate the post-injury degree of fracture,and the type of fracture was evaluated according to Gartland classification.X-ray reexamination 1-2 days after hospitalization was selected as postoperative X-ray measurement to evaluate the status of reduction.The final outpatient follow-up radiographs were selected for follow-up X-ray measurements to evaluate the final radiological efficacy.A telephone follow-up clinical evaluation questionnaire was designed to evaluate the appearance and function of the affected limb.SPSS20.0 was used for statistical analysis.SPSS20.0 was used for statistical analysis.For measurement data,mean ± standard deviation was collected,and mean values between the two groups were compared according to the homogeneity test of variance.Independent sample t test or non-parametric test was used.For counting data,collected numbers,percentages,and inter-group comparisons,Chi-square test or Fisher test were used.Result :A total of 176 children were included in this study,including 106 males and70 females,all of whom had Gartland III supracondylar fractures of the humerus.According to the surgical treatment methods,they were divided into open reduction Kirschner wire internal fixation group(abbreviated as incision group,N=100)and olecranon bone traction group(abbreviated as bone traction group,N=76).The follow-up time was 1.94 to 8.34 years,with an average of 4years.Compared the two groups in gender(P=0.241),time from admission to surgery(P= 0.159),length of soft tissue in anteroposteric X-ray after injury(anteroposteric: P=0.44,lateral: P=0.944),the length of soft tissue at the broken end of X-ray lateral fracture after injury(P=0.301),and the displacement degree at the broken end of X-ray antero-lateral fracture after surgery(antero-lateral fracture:P=0.156,lateral fracture: P=0.338),positive X-ray Baumann’s Angle(P=0.57),positive X-ray forearm valvarus angle(P=0.12),telephone follow-up parent composition(P=0.944)and satisfaction(P=0.093),internal and external elbow inversion(P=0.074)and nerve injury(P=0.81),no significant difference were found in the two groups.There were significant differences in age composition(P=0.000126),length of hospital stay(P < 0.001),hospitalization cost(P=0.012),and lateral epiphyseal trunk angle of the lateral humerus condyle(P=0.000034)in the two groups.The mean hospital stay in the bone traction group was 3.86 times longer than that in the open reduction group,and the mean hospital stay in the open reduction group was 1.14 times longer than that in the bone traction group.Conclusion :Regardless of hospital stay and cost,there was no significant difference in clinical efficacy and prognosis between olecranon traction and open reduction and Kirschner wire internal fixation in the treatment of refractory Gartland III supracondylar humerus fractures in children.For type III supracondylar fractures of the humerus,there is no single approach that is universally applicable to the treatment of severely displaced supracondylar fractures in children.In these serious cases,no matter what treatment is used,treatment must be chosen carefully and vigilance must be maintained at all times. |
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