Clinical Observation For The Treatment Of Medial Humeral Epicondyle Fracture In Children By Two Internal Fixation Methods Combined Fumigation And Washing With Chinese Medicine

Objective: To compare the two different internal fixation methods between Kirschner wire and cannulated screws for the treatment of humeral epicondyle fractures in children,explore the advantages and disadvantages in the treatment by two different internal fixation methods with fumigation and washing of traditional Chinese medicine,and provide clinical basis and standardized treatment plan for the selection of internal fixation for humeral medial epicondyle fractures in children.Methods: In this study,retrospective analysis was used to select the cases of humeral medial epicondyle fractures that were treated in the Department of Pediatric Orthopaedics of Affiliated Hospital of Shandong University of Traditional Chinese Medicine from October 2014 to October2019.They were divided into observation group(Open reduction and fixation with Kirschner wire group)and control group(Open reduction and internal fixation with hollow screw group).Both groups were treated with Huoxue Zhitong Fumigant Lotion and functional exercise after operation.Data such as the length of operation,immobilization time,fracture healing,complications,and Modified An and Morrey elbow function scores were used as observation indicators to compare the effects of two surgical fixation methods on patients with humeral epicondyle fractures.Results: A total of 50 cases that met the inclusion criteria and obtained effective follow-up were finally included in this study,25 cases in the observation group(Open reduction and fixation with Kirschner wire group)and 25 cases in the control group(Open reduction and internal fixation with hollow screw group).In terms of operation time,the observation group was 93.16 ± 6.37 minutes and the control group was 109.96± 10.03 minutes.After t-test,there was a very significant difference between the two groups of data(P <0.01).In terms of immobilization time,the observation group was 3.96 ± 0.20 weeks and the control group was 3.76± 0.44 weeks.After t-test,there was a significant difference between the two groups of data(P <0.05).The total complication rates of the observation group and the control group were 8% and 32%,respectively.After Chi-square test,the complication rates of the two groups were significantly different(P <0.05).The modified An and Morrey elbow joint function scores of the two groups showed that the excellent and good rates of the observation group and the control group were 72.0% and 96.0% at three months after operation.The comparison of the excellent and good rates between the groups was based on the rank sum test.Z =-2.023,P = 0.043,P <0.05,the difference was significantly.At 6 months after surgery,the excellent and good rates of the observation group and the control group were 92.0% and 100.0%,respectively.The comparison of the excellent and good rates between the groups,using the rank sum test,Z =-0.470,P =0.639,P> 0.05,there was no statistical significance.Conclusion: Patients in both groups achieved satisfactory results after surgery.Among them,the open reduction and internal fixation with hollow screw for humeral medial epicondyle fractures have shorter immobilization time and faster functional recovery after surgery.And open reduction and fixation with Kirschner wire fixation requires less operation time and less complications.Therefore,in clinical work,the two internal fixation methods can be reasonably selected and applied according to the age of the child,the severity of soft tissue injury,the degree of obesity,and the size of the fracture fragments.Traditional Chinese medicine fumigation and washing assisted postoperative functional exercise can achieve good results,reflecting the advantages of integrated traditional Chinese and western medicine in treating children’s humeral medial epicondyle fractures,which should be promoted.