| ObjectiveObserving the treatment of extension-type of supracondylar fracture of humerus in children with three different ways, an appropriate and effective treatment is summarized, the prevention of its complications is explored, which provide a scientific basis for chinese medicine theory treating extension-type of supracondylar fracture of humerus in children.Method135 patients were selected from the TCM hospital of Dong Guan between May 2005 and June 2009, who were diagnosed for extension-type of supracondylar fracture of humerus with clinical examination and X-ray inspection. According to treatment, They were divided into the group of bone traction with external application of chinese medicine (n=45), the group of splint (n=45) and the group of closed reduction and kirschner wire internal fixation(n=45). After treating, patients were followed up, and evaluated in activity, strength, stability and pain with the evaluation criteria of improved elbow function of An and Morrey. carrying angle and baumann angle were observed, too.Result1. All patients were followed up for 4-8 months, the average time was 6 months. There were 3 cases lost in the group of splint,2 cases lost in the group of bone traction with external application of chinese medicine and 1 case lost in the group of closed reduction and kirschner wire internal fixation. In the complication, there were 5 cases of cubitus varus(3 cases in the group of splint,1 case in the group of bone traction with external application of chinese medicine and 1 case lost in the group of closed reduction and kirschner wire internal fixation) and 2 cases of myositis ossificans(1 case in the group of splint and 1 case lost in the group of closed reduction and kirschner wire internal fixation).2. In the comparison of carrying angle and Baumann angle, there was a statistically significant difference between the angles of lifting the fixed and the angles of preoperative (P<0.05), and there was a statistically significant difference between the angles of follow-up and the angles of preoperative (P<0.05). But there was no a statistically significant difference between the angles of follow-up and the angles of lifting the fixed (P>0.05).In the comparison of the three groups, there were no a statistically significant difference (P>0.05), except the angles of preoperative. there were a statistically significant difference (P<0.05) in the angles of follow-up and lifting the fixed.3. In the evaluation of activity, strength, stability, and pain, the group of splint were 48.13±9.15,7.52±2.96,4.71±3.64,7.71±4.34, the group of closed reduction and kirschner wire internal fixation were 53.20±7.12,9.45±2.60,9.82±2.92,8.64±2.43, the group of bone traction with external application of chinese medicine were 57.04±7.44,9.58±2.64,9.77±2.93,9.21±2.55. there was a statistically significant difference between the group of bone traction with external application of chinese medicine and the other two group (P<0.05). In the overall evaluation, there was a statistically significant difference between the group of bone traction with external application of chinese medicine and the other two group (P<0.05)Conclusion1. In carrying angle and baumann angle, three methods can effectively correct two angles, but compared with the method of splint external fixation, the method of closed reduction and kirschner wire internal fixation and the method of bone traction with external application of Chinese medicine can improve two angles better.2. In the evaluation, with the evaluation criteria of improved elbow function of An and Morrey, the method of closed reduction and kirschner wire internal fixation and the method of bone traction with external application of chinese medicine are better than the method of splint external fixation. But in improving activity, the method of bone traction with external application of chinese medicine is a little better than the method of closed reduction and kirschner wire internal fixation.3. There are fewer complications in the research, but the problems of three ways are worth further thought. We believe that the method of bone traction with external application of chinese medicine is effective in treating extension-type of supracondylar fracture of humerus, which the method is simple, simple, little damage, good function. So it is worthy of recommending. |
