Closed Reduction Blinding Pinning Of Severely Displaced Supracondylar Fractures Of The Humerus In Children: Study On The Clinical Results Comparison With The Open Reduction Internal Fixation

Objective:To identify the roles of the technique of the CRBP(Closed Reduction Blinding Pinning) in treating the severely displaced supracondylar fractures of the humerus in children,by comparing the clinical results between CRBP group and ORIF(Open Reduction Internal Fixation) group.Methods:We performed a retrospective review of typeⅢsupracondylar fractures of the humerus in children who were treated at our hospital from January 2005 to May 2008.The study has an enrollment of 104 patients with comprehensive clinical data after a review of patient notes and followed radiographs.There were 64 boys and 40 girls with a mean age of 6.6years(range,2 to 14 years).The mean follow-up time was 18 months(range,10 to 38 months).Seventy-six patients were managed with CRBP.The remaining twenty-eight managed with ORIF.The primary study end points were the duration of the procedure,the causes affecting the function of the elbow and the change of carrying angle.The clinical results were graded according to the criteria of Flynn,which are based on the carrying angle and elbow motion.Results:The CRBP group and the ORIF group were similar in terms of mean age,sex distribution,and preoperation displacement.There was some difference in the injured elbow side which didn't affect the final outcome.The mean duration of the operative procedure,between the CRBP group(44.5±17.9min) and ORIF group(94.5±28.1 min),was significant difference(P＜0.05);The limitation elbow range of motion between the CRBP group(4.1±6.3°) and ORIF group(15.7±8.5°),was significant difference(P＜0.05).There was significant difference(P＜0.05) in the limitation elbow range of motion beween the anotomic reduction patients(1.4±2.3°) in the CRBP group and ORIF group(15.7±8.5°). There was significant correlation(P＜0.05) between the loss of the the humerocondylar angle(HCA) and the limitation elbow range of motion and was no significant correlation (P＞0.05) between the limitation elbow range of motion and the loss of carrying angle. There were also significant differences(P＜0.05) between groups with respect to the ulnar displacement and non-ulnar displacement,ulnar tilt and non-ulnar tilt.Conclusions:With use of the technique of the CRBP,the clinical outcome is rather satisfactory.The elbow can early restore full function.The limition elbow range of motion was not serious and the incidence of cubitus varus is low via ORIF group.There is mini-scar in the skin which is no cosmetic loss.Clinical results of application CRBP method is encouraged and satisfactory comparison with ORIF in the management of the completely displaced extension supracondylar fractures of the humerus in children and CRBP is very acceptable.