Comparison of intraoperative manual reduction and Kirschner wire prying reduction in the treatment of completely displaced supracondylar Gartland type Ⅲ fracture of humerus in children

CHEN Jin; CHE Wei; ZHU Qing-hua; WANG Qiang

doi:10.11659/jjssx.10E023049

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Comparison of intraoperative manual reduction and Kirschner wire prying reduction in the treatment of completely displaced supracondylar Gartland type Ⅲ fracture of humerus in children

Clinical Research | 更新时间：2024-11-18

- Comparison of intraoperative manual reduction and Kirschner wire prying reduction in the treatment of completely displaced supracondylar Gartland type Ⅲ fracture of humerus in children
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 33, Issue 11, Pages: 1014-1017(2024)
- 作者机构：
  
  皖南医学院弋矶山医院小儿外科，安徽芜湖 241000
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.10E023049
  CLC： R683.4
- Published：25 November 2024，
  
  Received：11 October 2023，
- 稿件说明：
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陈进,车伟,朱庆华等.术中手法复位与克氏针撬拨复位治疗完全移位儿童肱骨髁上Gartland Ⅲ型骨折疗效对比[J].局解手术学杂志,2024,33(11):1014-1017.

CHEN Jin,CHE Wei,ZHU Qing-hua,et al.Comparison of intraoperative manual reduction and Kirschner wire prying reduction in the treatment of completely displaced supracondylar Gartland type Ⅲ fracture of humerus in children[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(11):1014-1017.
陈进,车伟,朱庆华等.术中手法复位与克氏针撬拨复位治疗完全移位儿童肱骨髁上Gartland Ⅲ型骨折疗效对比[J].局解手术学杂志,2024,33(11):1014-1017. DOI： 10.11659/jjssx.10E023049.

CHEN Jin,CHE Wei,ZHU Qing-hua,et al.Comparison of intraoperative manual reduction and Kirschner wire prying reduction in the treatment of completely displaced supracondylar Gartland type Ⅲ fracture of humerus in children[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(11):1014-1017. DOI： 10.11659/jjssx.10E023049.

摘要

目的

对比术中应用手法复位与克氏针撬拨复位治疗完全移位儿童肱骨髁上Gartland Ⅲ型骨折的疗效。

方法

选取2021年9月至2022年4月于我院就诊的完全移位肱骨髁上Gartland Ⅲ型骨折44例患儿，随机分为撬拨组和手法组，每组22例。比较2组患儿手术时间、术中透视次数、骨折愈合时间、术后6个月疗效以及术后并发症（感染、尺神经损伤、骨化性肌炎、肘内外翻畸形）情况。

结果

44例患儿均完成手术，无切开病例，其中手法组患儿有2例多次尝试手法复位不满意，术中改克氏针撬拨复位，剔除手法组中该2例患儿。撬拨组患儿手术时间为（39.59±5.59）min，短于手法组的（57.50±9.28）min；撬拨组患儿术中透视次数为（7.73±1.98）次，少于手法组的（15.60±3.20）次，差异均有统计学意义（

0.05）。术后6个月，2组患儿疗效优良率比较，差异无统计学意义（

0.05）。所有骨折均于术后4~6周愈合，2组患儿骨折愈合时间及术后并发症发生率比较，差异无统计学意义（

0.05）。

结论

对于儿童完全移位肱骨髁上Gartland Ⅲ型骨折，术中克氏针撬拨复位可缩短手术时间，减少术中透视次数，是一种具有安全、方便、可靠、创伤小等优点的复位方法。

Abstract

Objective

To compare the effects of intraoperative manual reduction and Kirschner wire prying reduction in the treatment of completely displaced supracondylar Gartland type III fracture of humerus in children.

Methods

Forty-four children with completely displaced supracondylar Gartland type III fracture of humerus who came to our hospital from September 2021 to April 2022 were selected and randomly divided into the prying group and the manual group， with 22 cases in each group.The operation time，number of intraoperative fluoroscopy， fracture healing time， curative effect 6 months after operation and postoperative complications （infection， ulnar nerve injury， myositis ossificans， elbow inversion deformity） were compared between the two groups.

Results

All 44 children completed surgery，without incision cases. In the manual group， 2 children were dissatisfied with manual reduction after repeated attempts and finally changed to Kirschner wire prying reduction，who were excluded in the follow-up study.The operation time was （39.59±5.59） minutes in the prying group， which was shorter than that of （57.50±9.28） minutes in the manual group； the number of intraoperative fluoroscopy was （7.73±1.98） in the prying group， which was less than that of （15.60±3.20） in the manual group， and the differences were statistically significant （

0.05）. Six months after operation， there was no significant difference in the excellent and good rate of curative effect between the two groups （

0.05）.All the fractures healed from 4 to 6 weeks after surgery. There was no significant difference in the healing time or incidence of postoperative complications between the two groups （

0.05）.

Conclusion

For completely displaced supracondylar Gartland type III fracture of humerus in children， Kirschner wire prying reduction can shorten operation time and reduce intraoperative fluoroscopy，which is a safe，convenient， reliable reduction method with less traumas.

关键词

克氏针骨折肱骨髁上撬拨复位手法复位临床疗效

Keywords

Kirschner wirefracturesupracondylar of humerusprying reductionmanual reductionclinical effect

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