Clinical Analysis For The Treatment Of Supracondylar Fracture Of Children (the Gartland â…¢ Type) By Open Reduction And Fixation With Lateral Two Parallel Kirschner Wire

Objective: Explore the incision to reset the outside of two parallel Kirschner wirefixation for the treatment of children supracondylar fracture of humerus (the Gartland Ⅲ),clinical efficacy, analysis of its role in the prevention of cubitus varus and iatrogenic ulnarnerve injury and other complications. Methods: Randomly selected60cases of theinstability of children included in the standard treatment of humeral condylar fractures(the Gartland type Ⅲ) patients.Divided into group A and group B according to thedifferent treatment methods, A group of40patients choice of treatment lateral openreduction and two parallel Kirschner wires. Group B,20cases of fixed C-arm fluoroscopymachine downlink closed reduction and cross Kirschner surgery.Two groups were gender,age and distribution of disease－bit comparison, no significant difference betweencomparable. Postoperative carrying angle of the two groups were changes in activity ofelbow function, the incidence of cubitus varus, the occurrence of iatrogenic ulnar nerveinjury, and overall efficacy were compared to evaluate the incision reset two parallelKirschner wire fixation for the treatment of humeral supracondylar fracture (the GartlandⅢ), clinical efficacy, and further analysis of the surgical approach in the prevention ofcubitus varus and iatrogenic ulnar nerve injury complications. Results:60patients withfractures healed completely, no forearm ischemic contracture, myositis ossificans andother complications. Roup A carrying angle to reduce the degree is obviously due to groupB, to prove that the group A in the prevention of cubitus varus was significantly better thangroup B. Occurred in1patient in group A patients with mild cubitus valgus, nooccurrence of iatrogenic ulnar nerve injury cases. Group B patients did not occur cubitusvalgus, and iatrogenic ulnar nerve injury cases.No case of intraoperative ulnar nerveinjury in group A and Group B patients, Prove in group A than group B prevent the occurrence of intraoperative ulnar nerve injury. Group A and Group B in the postoperativefinal follow-up elbow joint activities by statistical analysis did not differ between the twogroups can obtain good effect. According to Flynn evaluation criteria: A high rate oftreatment group92.50%, B group after treatment, excellent rate75.00%, by the Z test, Z=－3.35, P <0.05, significant difference. That fixed after treatment in group A (outside ofthe open reduction and two parallel Kirschner excellent rate was significantly higher thangroup B (closed reduction and percutaneous Kirschner wire fixation).Conclusion:1.Open reduction and two parallel Kirschner wire fixation for the treatment of humeralsupracondylar fracture (the Gartland Ⅲ type) operation is simple, and ends on the line,exposed to a clear vision surgery, do not have to repeatedly reset during surgery to avoidaggravating the elbow injury, elbow functional recovery, and a low incidence of cubitusvarus, and can reduce or even avoid serious complications such as iatrogenic ulnar nerveinjury. It has many advantages, provided the reference for the surgical treatment ofhumeral supracondylar fracture (the Gartland Ⅲ type)2. Closed reduction andpercutaneous cross Kirschner treatment of humeral supracondylar fracture (the GartlandⅢ type) trauma, surgery scar, etc., but the incidence of cubitus varus is still high, and iseasy to cause iatrogenic ulnar nerve injury and other serious complications. This not onlyincreases the risk of orthopedic surgery again, and may have serious consequences forpatients.