Clinical analysis of Kirschner wire prying assisted reduction for treating humeral supracondylar Gartland ⅢB/Ⅳ type fracture in children
Objective To investigate the clinical effect of Kirschner wire prying assisted reduction in the treatment of extremely unstable humeral supracondylar Gartland ⅢB/Ⅳ type fracture in children. Methods Thirty-seven children patients with diagnosed humeral supracondylar Gartland ⅢB/Ⅳ type fracture in this hospital from September 2021 to August 2022 were selected.After two unsuccessful attempts at manu-al reduction during the operation,the Kirschner wire prying was used to assist in reduction and complete per-cutaneous Kirschner wire fixation.The operation time,fracture healing time,intraoperative ulnar nerve injury,postoperative superficial and deep infection,ossifying myositis and elbow varus deformity were recorded.The function of elbow joint in the affected side was evaluated by the Flynn score in postoperative 6 months. Results All operations in the children patients were successfully completed.No case was converted to open operation and had ulnar nerve injury.The mean operation time was (45.78±10.35)min.All children patients were followed up after the operation.The fracture healing time after the operation in all children patients was 4-6 weeks,with an average time of (5.14±0.67)weeks.No case of superficial and deep infection was found during the postoperative follow-up,and no case of ossifying myositis and elbow varus deformity was found.In the elbow joint Flynn score in postoperative 6 months,there were excellent in 30 cases,good in 6 cases,medi-um in 1 case,the excellent and good rates reached 97%.Conclusion Kirschner wire prying assisted reduction in the treatment of humeral supracondylar Gartland ⅢB/Ⅳ type fracture in children has definite effect,this technique has the advantages of small trauma,simple operation and safety,which is worthy of promotion.