Clinical Observation Of Treatment Of Children With Extension Type Of Supracondylar Fracture Of The Three Methods

Objectives:To audit the outcomes of three treatments of displaced extension supracondylar fractures of the humerus in children and to search the utility approachs.Methods:We retrospectively reviewed 77 childrens with complete presentation of extension supracondylar fractures of the humerus between September 2005 and January 2007.They were divided into three groups,28 childrens were managed by the manipulative reduction combination splint(group A),24 by the internal fixtion with per cutem crossing kirschner wires(group B) and 23 by the open reduction and internal fixation(group C).Final outcome in the study was assessed using clinical (flexion-extension arc,carrying angle and Flynn grade) and radiographical(the Baumann angle) criteria after the union of fractures.Results:The manipulative reduction combination splint group,the internal fixtion with per cutem crossing kirschner wires group and the open reduction and internal fixation group were similar in terms of mean age,sex distribution,and fracture displacement.The manipulative reduction combination splint group,the internal fixtion with per cutem crossing kirschner wires group were surpass to the open reduction and internal fixation group in terms of times of union of fractures and return to function.There were no cases of iatrogenic injury and myositis ossificans in either group.The open reduction and internal fixation group was inferior to the front two groups in term of the rates of cubitus varus.There were also no significant differences (P＞0.05) between groups with respect to Flynn grade,the Baumann angle,change in the Baumann angle,canting angle,elbow flexion,elbow extension,total elbow range of motion,return to function.Conclusions:With use of the three specific techniques employed in this study, pin fixation per cutem are effective in the treatment of completely displaced extension supracondylar fractures of the humerus in children,with shorter time of the union of fractures,return to function better,less complications or sequelas.Both of them are effective in the treatment of extension supracondylar fractures of the humerus in children.Open reduction and internal fixation has some ascendencies in the treatment,but the indcations is to be controlled strictly.