Clinical Effect Of Blood-Letting Therapy Combined With Closed Manipulative Reduction And Percutaneous Kirschner Wire Fixation On Gartland Type Ⅲ Supracondylar Fracture Of Humerus In Children

Objective: To observe the clinical effect of blood-letting therapy combined with closed manipulative reduction and percutaneous Kirschner wire fixation on Gartland type Ⅲ supracondylar fracture of humerus in children,so as to provide basis for the clinical application of blood-letting therapy in Gartland type Ⅲ supracondylar fracture of humerus in children.Methods: From December 2019 to December 2020,60 children with Gartland type Ⅲ supracondylar fracture of humerus admitted to the Department of orthopedics and traumatology,Zhangzhou Hospital of traditional Chinese Medicine Affiliated to Fujian University of traditional Chinese medicine were randomly divided into two groups according to the random number table.The control group was given basic treatment,closed manipulative reduction and percutaneous Kirschner wire fixation,and the experimental group was given blood pricking therapy combined with closed manipulative reduction and percutaneous Kirschner wire fixation.The time from injury to admission,the time from injury to operation,the pain score of Wong-Baker facial expression pain scale on admission and the1 st,3rd and 5th day after operation were recorded.The circumference of affected limb and healthy limb before operation,the 2nd,5th and 7th day after operation were measured.The swelling values of affected limb before operation,2nd,5th and 7th day after operation were obtained and recorded the operation time,the times of manipulative reduction,the times of fluoroscopy,the time of fracture healing and the complications during the treatment were recorded.Through SPSS statistical analysis,draw a conclusion.Result:1.There was no significant difference in age,gender,distribution of affected side,time from injury to admission,time from injury to operation between the two groups(P > 0.05).2.Wong Baker pain score: Pain was scored by Wong Baker facial expression pain scale.There was no significant difference in Wong Baker pain score between the two groups at admission(P > 0.05).Inter group comparison: the Wong Baker pain scores on the 1st,3rd and5 th day after operation in the experimental group were lower than those in the control group,with statistical significance(P < 0.05);intra group comparison: the Wong Baker pain scores on admission,1st,3rd and 5th day after operation in the two groups were compared,with statistical significance(P < 0.05).3.Swelling value of affected limb: There was no significant difference in circumference of healthy limb,circumference of affected limb and swelling value of affected limb between the two groups before operation(P > 0.05).Inter group comparison: the swelling value of the affected limb in the experimental group was lower than that in the control group on the 2nd,5th and 7th day after operation,and the difference was statistically significant(P < 0.05);intra group comparison: the swelling value of the affected limb in the two groups was compared before operation and on the 2nd,5th and 7th day after operation,and the swelling value decreased with the progress of time,and the difference was statistically significant(P <0.05).4.Swelling efficacy standard: Comparison between groups: The swelling efficacy of the experimental group was higher than that of the control group,the difference was statistically significant(P < 0.05).5.Operation time,intraoperative reduction times and intraoperative fluoroscopy times:Comparison between the two groups: The operation time,intraoperative reduction times and intraoperative fluoroscopy times from closed manipulative reduction to percutaneous Kirschner wire internal fixation in the experimental group were less than those in the control group,and the difference was statistically significant(P < 0.05).6.Fracture healing time: Comparison between groups: There was no significant difference between the experimental group and the control group(P > 0.05).7.Clinical complications: After 3 months follow-up,there was 1 case of ulnar nerve injury in the control group.After symptomatic treatment,ulnar nerve returned to normal after2 months.There were no other complications in the two groups.Conclusion: Blood-letting therapy combined with closed manipulative reduction and percutaneous Kirschner wire fixation in the treatment of Gartland type Ⅲ supracondylar fracture of humerus in children can effectively relieve pain and swelling of affected limb,improve clinical symptoms,facilitate intraoperative fracture closure manipulative reduction,shorten operation time,reduce intraoperative radiation exposure,etc.,which is better than simple closed manipulative reduction and percutaneous Kirschner wire fixation.It is not considered that pricking blood therapy has influence on fracture healing time.