Objective

2

To compare and analyze the clinical efficacy of small incision-assisted Kirschner wire joystick technique for prying reduction and internal fixation versus small-incision Kirschner wire cross-internal fixation in the treatment of humeral medial epicondylar fractures in adolescent.

Methods

2

A retrospective analysis was conducted on the clinical data of 94 pediatric patients with humeral medial epicondylar fractures admitted to our hospital from January 2021 to January 2024. They were divided into the joystick group （47 cases） and the cross-fixation group （47 cases） based on different surgical protocols. Patients in the joystick group underwent small incision-assisted Kirschner wire joystick technique for prying reduction and internal fixation， while patients in the cross-fixation group received small-incision Kirschner wire cross-internal fixation. Perioperative indicators， bone metabolism markers before and after surgery， visual analogue scale （VAS） scores at rest and during activity， elbow range of motion， elbow function recovery， and complication of patients were compared between the two groups.

Results

2

The joystick group had significantly shorter operation time， postoperative hospital stay， fracture healing time， and fewer intraoperative fluoroscopy frequency compared to the cross-fixation group （

P

<

0.05）. One month after surgery， the joystick group showed lower VAS scores at rest and during activity （

P

<

0.05）， higher serum levels of osteoprotegerin （OPG） and bone gla protein （BGP） （

P

<

0.05）， and a lower level of collagen C-terminal telopeptide （CTX） compared to the cross-fixation group （

P

<

0.05）. The joystick group demonstrated greater ranges of elbow flexion and extension， forearm pronation and supination than the cross-fixation group 3， 6， and 12 months after surgery（

P

<

0.05）. The excellent and good rate of elbow function recovery was higher in the joystick group than that in the cross-fixation group （

P

<

0.05）. No complications occurred in either group.

Conclusion

2

Compared with the small-incision Kirschner wire cross-internal fixation， the use of small incision-assisted Kirschner wire joystick technique for prying reduction and internal fixation in the treatment of adolescent humeral medial epicondylar fractures has the advantages of higher surgical efficiency， fewer fluoroscopy frequency， less postoperative pain， faster fracture healing， and better joint function recovery， without increasing the risk of postoperative complications.