| ObjectiveTo investigate the clinical effect of treatment of GartlandⅢsupracondylar fracture of the humerus in children using closed reduction and Kirschner wire fixation by percutaneous and how to use Baumann angle to predict cubitus varus.Methods75 cases that consistent with instituted internalize standard from Agust 2006 to June 2008 were retrospectively analysed and divided into two groups according to different method of treatment,group A(55 cases) were treated by using closed reduction and Kirschner wire fixation by percutaneous,group B(20 cases) were treated by using open reduction and internal fixation of Kirschner wire.There is comparatively no obvious difference between two groups concerning about gender,age and locational distribution of fracture.The Baumann angle after reduction,disbanding external fixation and during following-up,the mobile function of elbow joint,the incidence of cubitus varus and overall curative effect were compared and analysed in order to evaluate the clinical curative effect of treatment of GartlandⅢsupracondylar fracture of the humerus in children using closed reduction and Kirschner wire fixation by percutaneous.We respectively compared the around changes of each group's Baumann angle after reduction,disbanding external fixation and during following-up,and analyze the relationship between Baumann angle and cubitus varus,for evaluating the clinical value of measurement of Baumann angle after reduction to predict cubitus varus. ResultsAll the 75 cases were completely healed,without the complication of malunion, Volkmann's contracture,myositis ossificans and severe vascular and neurological injury.According to the standard of Flynn,the excellent rate of group A(87.3%) is remarkably higher than that of group B(65.0%),the difference is highly significant (analyzed statistically P＜0.01).The incidence of cubitus varus of group A(10.91%) is lower than that of group B(30.00%),the difference is significant(analyzed statistically P＜0.05);the mobile function of eblow joint of group A is superior to group B(analyzed statistically P＜0.05).The average value of Baumann angle of group A was 72.62°±4.35°after reduction,74.31°±5.18°after disbanding the external fixation,76.14°±4.33°during the following-up;the average value of Baumann angle of group B was 76.97°±2.94°after reduction,78.83°±2.97°after disbanding the external fixation,80.35°±3.40°during the following-up;Comparing the Baumann angle of two groups have significant difference (analyzed statistically P＜0.05),and the around changes of each group's Baumann angle after reduction,disbanding the external fixation and during following-up,there is no significant difference(analyzed statistically P＞0.05).The incidence of cubitis varus of Baumann angle greater than or equal to 80°after reduction is 70.00%,lower than 80°after reduction is 7.69%,there is very significant difference(analyzed statistically P＜0.01).Conclusion(1) The operation is simple,the fixation is firm,the mobile function of elbow joint recovers well and the incidence rate of cubitus varus is lower in the group of closed reduction and Kirschner wire fixation by percutaneous,which is superior to opened reduction and internal fixation,it should take the first choice method of treatment of GartlandⅢsupracondylar fracture of the humerus in children.(2) The Baumann angle is one kind of good target of evaluating effect of reduction.It is one kind of favourable method of preventing cubitus varus by adjusting the reduction,which was judged by measuring Baumann angle timely after reduction through fluoroscopy.Generally,it should be reduced again if Baumann angle is greater than or equal to 80°after reduction. |
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