Meta-analysis Of The Efficacy Of Closed With Small Incision Reduction And Internal Fixation For The Treatment Of Supracondylar Fracture Of The Humerus In Children

Objective:Meta-analysis was used to compare the effect of closed reduction and small incision open reduction and Kirschner wire internal fixation for the treatment of supracondylar fracture of the humerus in children.Methods:Collecting the relevant literatures on the treatment of children's supracondylar fractures of the humerus from January 1998 to June 2018 in the knowledge network of Wanzhi,Wanfang,Maite Sitron and Pubmed,and sorting out the basic information of the research subjects.And then use RevMan 5.3 software for statistical analysis.Results:A total of 14 articles were selected,including 1214 patients with supracondylar fractures of the humerus.Among them,560 patients underwent closed reduction and percutaneous needle insertion(ie,closed group),and 674 patients underwent Kirschner wire fixation(ie,incision group)with small incision.The results showed that the excellent rate of postoperative Flynn criteria was higher in the closed group(OR=1.49,95% CI=[1.02,2.18],P=0.04)compared with the incision group,and the postoperative hospitalization period was shorter(OR =-2.68,95% CI =[-3.06,-2.29],P < 0.00001);But the incidence of postoperative cubital varus was lower in the incision group compared with the closed group(OR = 3.15;95% CI = [1.13,8.75],P = 0.03),the incidence of postoperative ulnar nerve injury was also lower(OR = 4.22;95% CI =[1.63,10.93],P = 0.003);There were fewer intraoperative fluoroscopy(OR=3.02,95% CI=[2.67,3.37],P< 0.00001);the difference between postoperative infection rate and postoperative Baumann angle in the closed and incision groups The difference between the two aspects is not statistically significant.Conclusion:Through meta-analysis,it was found that the closed group and the incision group had their own advantages in the treatment of children with supracondylar fractures of the humerus.The closed group had the advantages of high excellent rate of Frenn standard and shortened hospitalization period.The incidence of varus and ulnar nerve injury is lower,and the number of intraoperative fluoroscopy is also less.There was no statistical difference between the two in terms of post-fracture wound or needle infection,postoperative Baumann angle difference.