唐氏手法复位小夹板与高分子绷带联合外固定治疗儿童Gartland III型肱骨髁上骨折的临床研究

A clinical study on treating Gartland III supracondylar fracture of the humerus in children by external fixation with a small splint and polymer bandages after Tang’s manual reduction

目的:探讨唐氏手法复位小夹板与高分子绷带联合外固定治疗儿童Gartland III型肱骨髁上骨折的临床疗效和安全性。方法:选择2015年9月-2019年9月在我院住院的70例儿童Gartland III型肱骨髁上骨折患者,随机分为两组。非手术组采用唐氏手法复位小夹板与高分子绷带联合外固定固定治疗;手术组采用闭合或有限切开复位克氏针内固定治疗。观察记录患者住院时间、住院治疗费用、骨折临床愈合时间和血管危象、携带角丢失等情况;随访观察患者功能恢复和肘内翻并发症发生情况,并采用肘关节Flynn临床功能评定标准评定总体疗效。结果:两组患者住院时间比较,差异无统计学意义;两组患者骨折均获得良好愈合,两组患者骨折临床愈合时间、住院治疗费用比较,差异均有统计学意义;两组治疗早期血管危象发生率比较,组间差异无统计学意义。至随访观察6个月时,两组患者肘内翻畸形发生率比较,差异无统计学意义;两组总体临床疗效比较,组间差异无统计学意义。结论:采用唐氏手法复位小夹板与高分子绷带联合外固定可以有效治疗儿童Gartland III型肱骨髁上骨折,其住院时间、并发症发生、总体疗效和安全性与克氏针内固定手术治疗相当,但其骨折愈合时间更短、治疗费用更低。

Objective: To investigate the clinical efficacy and safety of external fixation with a small splint and polymer bandages after Tang’s manual reduction on Gartland III supracondylar fractures of the humerus in children. Methods: 70 cases who were hospitalized in our hospital from September 2015 to September 2019 were selected and randomly divided into two groups. The non-surgical group was treated by external fixation with a small splint and polymer bandages after Tang’s manual reduction. The surgical group was treated by closed or limited open reduction and Kirschner wire internal fixation. Results: There was no statistically significant difference in the length of hospitalization between the two groups. The fractures in the groups were well healed, and the differences in the clinical healing time and hospitalization costs in the groups were statistically significant. There was no significant difference in the incidence of early vascular crisis between the groups. Up to 6 months of followed-up, there was no statistically significant difference in the incidence of cubitus varus between the groups. The overall efficacy between the groups showed no statistically significant difference. Conclusion: Tang’s manual reduction on Gartland III supracondylar fractures of the humerus in children was effective. The length of hospitalization, complications, overall efficacy and safety are equivalent to Kirschner wire internal fixation, and with shorter fracture healing time and lower treatment cost.