Short term efficacy and safety evaluation of closed reduction combined with percutaneous needle fixation through a small medial incision for the treatment of Gartland Ⅲ supracondylar fractures of the humerus in children
Short term efficacy and safety evaluation of closed reduction combined with percutaneous needle fixation through a small medial incision for the treatment of Gartland Ⅲ supracondylar fractures of the humerus in children
Objective To explore the short-term efficacy and safety evaluation of closed reduction combined with percutaneous needle fixation through a small medial incision for the treatment of Gartland Ⅲ supracondylar fractures of the humerus in children.Methods A total of 80 children with Gartland type Ⅲ supracondylar fracture of humerus treated in Suzhou Hospital Affiliated to Anhui Medical University from June 2019 to June 2023 were prospectively selected for clinical study.They were divided into the observation group and the control group according to the random number table method,with 40 cases in each group.The observation group received closed reduction combined with percutaneous nee-dle fixation through a small inner incision,while the control group received closed reduction percutaneous needle fixation.The surgical process in-dicators(operation time,blood less,length of hospital stay),fracture healing time,pain scores[visual analogue scale(VAS)scores]at 1,3,7 d after operation,elbow joint activity ability,elbow joint function,and occurrence of complications were compared between the two groups.Results The operation time and hospitalization time of the observation group were(66.9±8.1)min and(6.8±1.8)d,respectively,which were longer than those of the control group[(53.0±6.7)min and(5.5±1.5)d],the amount of bleeding was(48.0±5.6)mL,which was greater than that of the control group[(17.4±5.1)mL],and the differences were statistically significant(P＜0.05).There were no signifi-cant differences in VAS scores between the two groups before and 7 days after operation(P＞0.05);the VAS scores of the observation group at 1 and 3 days after operation were(2.74±0.69)and(1.43±0.52)points,respectively,which were higher than those of the control group[(2.21±0.53)and(1.31±0.48)points],and the differences were statistically significant(P＜0.05).At 4-6 weeks after operation,the elbow flexion and extension functions of the observation group were(129.6±7.0)°and(6.7±1.7)°,respectively,which were lower than those of the control group[(134.9±6.1)°and(8.4±1.8)°],and the differences were statistically significant(P＜0.05).There was no significant difference in elbow pain score,elbow motor function score,elbow activity stability score,daily activity ability score and Mayo total score between the observation group and the control group(P＞0.05).The surgical complication rate of the observation group was 2.50％,which was lower than that of the control group(20.00％),and the difference was statistically significant(P＜0.05).Conclusion The combination of closed reduction and percutaneous fixation with a small medial incision,as well as closed reduction and percutaneous needle fixation,has positive clinical effects in the treatment of Gartland Ⅲ supracondylar fractures of the humerus in children.The combination of percutaneous internal fixation with a small medial incision is more conducive to reducing surgical complications,especially with lower damage to the ulnar meridian.However,it re-quires longer surgical time,greater bleeding,slightly longer postoperative recovery time,and more severe pain in the early postoperative period.
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