| Objective: To summarize the method of manual closure reduction of supracondylar fracture of humerus in children by literature excavation and arrangement;To observe and analyze the clinical effect of rotating end extrusion in the treatment of the supracondylar fracture of humerus in gartlandii children.Methods:(1)Through the manual retrieval library and computer search knowledge network,Wanfang,VIP,Pub Med and other databases,the related literature of traditional Chinese medicine bone injury and related materials of books and medical records of various schools were collected,and the operation,efficacy and academic thought of closed reduction were summarized and summarized(2)58 children with supracondylar fracture of humerus who were treated by Tianjin hospital from June 2020 to January 2021 and met the standard of Natai were collected.According to the treatment method,it can be divided into the manual closed reduction group and the operation group.The closed reduction group(29 cases)was treated with rotary end extrusion and external fixation of gypsum,while 29 cases in the operation group were fixed with Kirschner needle.The Baumann angle and anteversion of the distal humerus of the injured limb were collected and sorted out before and after the treatment,3 days after operation,3 weeks after operation,6 weeks after operation and 8 weeks after operation;The elbow joint activity of the two groups was collected 8 weeks after operation and evaluated according to Flynn score standard,and the clinical healing time was collected and recorded.Spss25.00 statistical software was used to analyze all the data.Result:(1)Plaster and splint fixation of the type Ⅱ children with supracondylar fracture of humerus is easy to operate and easy to be popularized in clinical.The procedure of olecranon traction fixation is more complicated than that of gypsum and splint,and skin traction is rarely used in clinical.(2)(1)there was no statistical difference between the two groups(P > 0.05),and there was no statistical difference between the two groups(P > 0.05).(2)Baumann angle comparison: there was a statistical difference between the 8 weeks after operation and the preoperative comparison between the manual closed reduction group(P < 0.05);There was a statistical difference between the 8 weeks after operation and the preoperative comparison in the operation group(P < 0.05);The difference between the two groups was not statistically significant(P > 0.05);(3)The difference between the two groups was statistically significant(P < 0.05),and the difference was statistically significant(P < 0.05)between the 8 weeks after operation and before operation(P < 0.05).After repeated measurement variance test,the two groups did not meet the spherical symmetry condition(P < 0.05),and the degree of freedom was corrected.The results of variance analysis of the image anteversion in different treatment methods were f = 6.896,P = 0.001,which showed that there was difference in the inclination of the image in different treatment modes.The results of the analysis of the variance of the anterior inclination of different treatment methods were f = 2.113 and P = 0.152,indicating that there was no difference between the groups.The results were similar to the single factor repeated measurement data.The two comparison of the inclination angle at different times showed that there was statistical difference between the manual closed reduction group and the operation group.(4)Clinical healing time: the average number of days of clinical healing in the operation group was 35.56 ± 2.21.The average number of days of clinical healing in manual closed reduction group was 33.28 ± 2.05,the manual closure reduction group was lower than that of the operation group(P < 0.05);(5)Elbow function score(Flynn score): the comparison between the groups: at 8 weeks after operation,there was no statistical difference(P > 0.05);(6)Deformity rate: the rate of deformity in the manual closed reduction group was20.7% and 17.2% in the operation group at 8 weeks after operation,and there was no statistical difference between the two groups(P > 0.05);The results showed that the deformity rate of the closed reduction group was 17.2%,the rate of operation group was 3.4%,and there was no statistical difference between the two groups(P > 0.05).Conclusion:For the type Ⅱ supracondylar fracture of the humerus,the results of rotary end extrusion plaster fixation and percutaneous internal fixation can be used to treat the children’s supracondylar gartlandii fracture.In 8 weeks,the two treatments corrected the anterior angle and Baumann angle of gartlandii type supracondylar fracture of humerus.The deformity rate of Baumann angle and anteversion angle of the two treatment methods was lower at 8 weeks,but the rotary end extrusion plaster fixation was better than that of the internal fixation with pichian needle in clinical healing time. |
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