He Ben-xiang, Zhang Bin, Tan Ya-jun
The Affiliated Sports Hospital of Chengdu Sports College, Chengdu 610041, Sichuan, China.
Zhongguo Gu Shang. 2009 Mar;22(3):190-2.
To compare clinical effects and the incidence rates of cubitus varus in displaced humeral supracondylar fractures treated with different kinds of external fixation.
Among 226 children with displaced humeral supracondylar fractures, 134 patients were male and 92 patients were female, ranging in age from 5 to 12 years, with an average of 8.58 years. After manipulative reduction, the patients were treated with three kinds of external fixation: the 88 patients (51 males and 37 females, ranging in age from 5.1 to 12 years) in Group A were treated with double external fixations of small splint and moulding splint; 74 patients (44 males and 30 females, ranging in age from 5 to 11.8 years) in Group B were treated with small splint; and 64 patients (39 males and 25 females, ranging in age from 5.5 to 12 years) in Group C were treated with plaster slab. The indexes such as healing time of fractures, the functions of elbow joint and cubitus varus were observed. The clinical effects and the incidence rates of cubitus varus in three groups were compared.
All the patients were followed-up, and the duration of follow-up ranged from 6 months to 4 years, with an average of 25 months. According to the standard for efficacy evaluation, in Group A, 59 patients got an excellent result, 23 good, 6 bad, the excellent and good rate was 93.18%; in Group B, above data were 37, 29, 8, 89.19% respectively; while in Group C, the data were 20, 31, 13 and 79.69% respectively. The incidence rates of cubitus varus of three groups were 6.82%, 17.57% and 32.81% respectively. The result of statistical analysis demonstrated that there were significant differences of the clinical effects and the incidence rates of cubitus varus in three groups (P<0.05). Comparison of the clinical effects: Group A was better than Group B and Group C, Group B was better than Group C. The incidence rates of cubitus varus: Group A was lower than Group B and Group C, Group B was lower than Group C.
The therapeutic effects of double external fixation is the best among three groups. The double external fixation had follow advantages: external fixation, high stability, strong anti-rotation ability, and joint function quick recovery, the incidence rates of cubitus varus lower and good clinical effects. So double external fixation method should be the first choose for the treatment of humeral supracondylar fractures.
比较不同种类外固定治疗小儿肱骨髁上骨折的临床效果及肘内翻发生率。
226例小儿肱骨髁上骨折患者，男134例，女92例；年龄5～12岁，平均8.58岁。手法复位后，采用三种外固定方法治疗：A组88例（男51例，女37例；年龄5.1～12岁），采用小夹板与塑形夹板双重外固定；B组74例（男44例，女30例；年龄5～11.8岁），采用小夹板外固定；C组64例（男39例，女25例；年龄5.5～12岁），采用石膏托外固定。观察骨折愈合时间、肘关节功能及肘内翻等指标，比较三组的临床效果及肘内翻发生率。
全部患者均获随访，随访时间6个月～4年，平均25个月。按疗效评价标准，A组优59例，良23例，差6例，优良率93.18%；B组分别为37例、29例、8例，优良率89.19%；C组分别为20例、31例、13例，优良率79.69%。三组肘内翻发生率分别为6.82%、17.57%、32.81%。统计学分析结果显示，三组临床效果及肘内翻发生率差异有统计学意义（P<0.05）。临床效果比较：A组优于B组和C组，B组优于C组。肘内翻发生率：A组低于B组和C组，B组低于C组。
三组中双重外固定治疗效果最佳。双重外固定具有外固定稳定、抗旋转能力强、关节功能恢复快、肘内翻发生率低、临床效果好等优点，应作为小儿肱骨髁上骨折治疗的首选方法。
