闭合复位与切开复位克氏针内固定治疗肱骨髁上骨折患儿的效果及其对肘关节功能、肘关节活动度的影响

Effect of Closed Reduction and Open Reduction Kirschner Wire Internal Fixation on Supracondylar Fracture of Humerus and Its Influence on Elbow Function and Eelbow Motion

目的分析肱骨髁上骨折患儿接受闭合复位与切开复位克氏针内固定治疗的效果及其对肘关节功能、肘关节活动度的影响。方法选取2021年10月—2023年10月广东省梅州市五华县人民医院骨外科收治的102例肱骨髁上骨折患儿为研究对象,按照随机数字表法将其分为切开组与闭合组,各51例。切开组采用切开复位克氏针内固定治疗,闭合组采用闭合复位克氏针内固定治疗。对比两组患儿的临床指标、肘关节功能、肘关节活动度、并发症发生情况。结果闭合组骨折愈合、手术、住院时间均短于切开组,术中出血量少于切开组,组间差异有统计学意义(P<0.05);术后1、3个月,两组患儿的Mayo肘关节功能量表各个维度评分比较,组间差异无统计学意义(P>0.05);两组患儿屈肘、伸肘、过伸活动度比较,组间差异无统计学意义(P>0.05);两组患儿并发症发生率比较,差异无统计学意义(P>0.05)。结论闭合复位克氏针内固定能够缩短肱骨髁上骨折患儿骨折愈合、住院及手术时间,减少术中出血量,优于切开复位克氏针内固定治疗;但在术后肘关节功能、肘关节活动度恢复及并发症发生率方面,两者效果相当。

Objective To analyze the effect of closed reduction and open reduction Kirschner wire internal fixation on supracondylar fracture of humerus and its influence on elbow function and elbow motion.Methods A total of 102 children with supracondylar fracture of humerus admitted to the Department of Orthopedics in Wuhua County People's Hospital of Meizhou City,Guangdong Province from October 2021 to October 2023 were selected as the research objects,and were divided into an open group and a closed group according to random number table method,with 51 cases in each group.The open group was treated with open reduction Kirschner wire internal fixation,and the closed group was treated with closed reduction Kirschner wire internal fixation.The clinical indexes,elbow joint function,elbow joint motion and complications were compared between the two groups.Results The fracture healing,operation and hospital stay in the closed group were shorter than those in the open group,and the intraoperative blood loss was less than that in the open group,the differences between groups were statistically significant(P<0.05).At 1 and 3 months after surgery,there was no significant difference in Mayo elbow joint function scale scores between the two groups(P>0.05).There was no significant difference in elbow flexion,elbow extension and hyperextension between the two groups(P>0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Closed reduction Kirschner wire internal fixation can shorten fracture healing,hospitalization and operation time,and reduce intraoperative blood loss in children with supracondylar fracture of humerus,which is superior to open reduction Kirschner wire internal fixation.However,the effects of the two methods were similar in elbow function,elbow motion recovery and complication rate.