A Systematic Review Of Early And Delayed Surgery For Gartland Ⅲ Supracondylar Fractures Of The Humerus In Children

Objective: Get through the study of the rate of conversion to open reduction,iatrogenic nerve injury rate, pin tract infections, cubitus varus, time of operation andunsatisfactory rate to futher clarify the clinical effect of early treatment(<12h) and delayedtreatment(>12h) for Gartland Ⅲ supracondylar fractures of the humerus in children.Methods: We have retrived one by one the following databases: Pubmed、EMbase、OVID、EBSCO、TomPson SCI、CNKI、WANFANG、VIP. Strict accordane with theinclusion criteria for literature selection, for a discussion of differences in the decision toorganize the program, RevMan5.1.2software for data analysis. Results: A total of6studisincluded483participants, all selected documents are used RevMan5.1.2software qualityevaluation, and showed no high-level literature. Compared the rate of conversion to openreduction in6studis, we found the difference was significant(RR=0.55，95%CI[0.39,0.78]，I2=0%，P=0.0007). We had compared iatrogenic nerve injury rate of3studis, found it was not significant. No significant differences were found in pin tractinfections in3studis. The difference on the rate of cubitus varus was not significant in onestudy. We also found it was not significant in the time of operation and the rate ofunsatisfactory. Conclusion: The evidence was based on closed Gartland Ⅲ supracondylarfractures of the humerus without vascular and neurological injury in children.Consequently we thought the surgery should be maded early as to the results of our study.The quality level of included studis in our study was not high, and lack of multi-center, alarge sample of RCTs, more experts can make further study of this issue.