Efficacy of towel clamp olecranon traction combined with different Kirschner wire internal fixation in the treatment of traumatic Gartland type Ⅲ supracondylar fracture of humerus in children
Objective To investigate the clinical application of different internal fixation methods of Kirschner wire in children with traumatic supracondylar fracture of humerus(Gartland type Ⅲ)based on the reduction of fracture fragments by using towel clamp olecranon traction,and to analyze the practicability of different regimens through imaging indicators.Methods From May 2021 to May 2022,83 children with traumatic supracondylar fracture of humerus(Gartland type Ⅲ)in the hospital were enrolled in the study.The above patients were grouped according to the reduction and internal fixation methods.All patients were treated with olecranon traction reduction with towel clamp and adopted internal fixation with different Kirschner wires[fan-shaped fixa-tion group(traction+Kirschner wire fan-shaped fixation,n=39),cross-fixation group(traction+Kirschner wire cross-fixation,n=44)].The healing status,loss status of flexion and extension and carrying angle,ultrasonic blood flow parameters,neurologi-cal function recovery,joint function recovery and complications were observed.Results The postoperative callus formation time and fracture healing time in the fan-shaped fixation group were significantly shorter than those in the cross-fixation group.There were no significant differences in the loss of flexion and extension and the loss of carrying angle between the fan-shaped fixation group and the cross-fixation group.There was a significant difference in the resistance index(RI)between groups at 4 and 8 weeks after surgery,and the RI in the fan-shaped fixation group was lower,and the decrease of RI was different in the fan-shaped fixa-tion group and the cross-fixation group.The recovery of neurological function in the fan-shaped fixation group was better than that in the cross-fixation group.No significant differences were shown in pain,stability,motor function,daily activities and total score of joint function between groups.There were no significant differences in the incidence of redisplacement,cubitus varus,infection and iatrogenic nerve injury between fan fixation group and cross fixation group.Conclusion For traumatic supracondylar humeral fractures(Gartland type Ⅲ)in children,both towel clamp olecranon traction combined with Kirschner wire fan-shaped fixation and cross Kirschner wire internal fixation can effectively maintain fracture reduction and restore joint function,but fan-shaped fixation may be relatively better in promoting healing and vascular nerve recovery.
supracondylar fracture of humerusclosed reductionolecranon tractionkirschner wireimaging
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