The Comparison Of Three Kinds Of Ways To Treat Supracondylar Fracture Of The Humerus In Children

Objective:Sum up the clinical experience of the treatment to the supracondylar fracture of the humerus in children, and investigate the curative effect,advantages and disadvantages of three kinds of ways.Methods:To review and analyze 55 cases of children with supracondylar fracture of the humerus in the period of January 2005 to October 2009, which was defined as type Gartlandâ…¢. There were 22 cases treated with open reduction and internal fixation by Kirschner wires, 15 cases treated with open reduction and internal fixation by absorbable screws, and 18 cases treated with closed reduction and external fixation by plaster. And these cases were classified as A,B,C three groups, according to the different treatment ways. Compared the age,sex,injury mechanism,fracture type of each group before treatment to confirm if there was comparability among the three groups. And using fracture healing time,flexion and extension function of elbow,Baumann angle,Carrying angle,total function of elbow as index to compare the curative effect of the different treatment ways.Results:There was no statistical significance on the difference of the age,sex,injury mechanism,fracture type among the three groups, and indicate there was comparability among the three groups.Fracture healing time:there was no statistical significance on the difference between group A and group B (P>0.05); there was statistical significance on the difference between group A and group C,group B and group C:group A>group C (P=0.020), group B> group C (P=0.047).The flexion and extension function of elbow:there was no statistical significance on the difference between group A and group B (P>0.05); there was statistical significance on the difference between group A and group C,group B and group C:group C was better than group A(P=0.002), group C was better than group B (P=0.003).The Baumann angle:there was no statistical significance on the difference between group A and group B (P>0.05); there was statistical significance on the difference between group A and group C,group B and group C:group A0.05); there was statistical significance on the difference between group A and group C,group B and group C:group A>group C (P=0.000), group B> group C (P=0.000).The total function of elbow:there was no statistical significance on the difference between group A and group B (P>0.05); there was statistical significance on the difference between group A and group C,group B and group C:group A was better than group C (P=0.034), group B was better than group C (P=0.025).Conclusion:1,Compared to the closed reduction with external fixation by plaster, the advantages of open reduction with internal fixation by Kirschner wires or absorbable screws in the children with supracondylar fracture of the humerus which is defined as type Gartlandâ…¢are these:the Carrying angle and the Baumann angle recover better, the total function of elbow recover better. And the disadvantages are these:the fracture healing time is longer, the flexion and extension function of elbow is restricted more.2,In the open reduction with internal fixation there is no remarkable difference between Kirschner wires and absorbable screws on the index of fracture healing time,flexion and extension function of elbow, Carrying angle,Baumann angle,total function of elbow. Use absorbable screws cost more in the first operation, but the complications are less, and need not to have a second operation to remove the internal fixation.