儿童肱骨髁上骨折闭合复位与切开复位结合克氏针固定的临床疗效比较

Comparison of Clinical Efficacy of Closed Reduction and Open Reduction Combined with Kirschner Wire Fixation for Supracondylar Humerus Fracture in Children

目的分析切开复位与闭合复位结合克氏针固定疗法在儿童肱骨髁上骨折(supracondylar fracture of humerus,SFH)中的临床疗效。方法选取2020年5月—2022年5月天水市第一人民医院收治的56例SFH患儿为研究对象,依据手术方案进行分组,每组28例。对照组开展切开复位+克氏针固定的治疗方法,观察组采取闭合复位+克氏针固定的方案,对比两组的临床优良率、临床一般观察指标及术后并发症发生情况。结果两组临床优良率、骨折愈合时间及术后并发症发生率对比,差异无统计学意义(P>0.05)。观察组的手术时间[(48.92±18.99)min]与住院时间[(4.08±1.85)d]均短于对照组[(98.65±29.45)min、(8.12±3.65)d],差异有统计学意义(t=7.510、5.224,P<0.05)。观察组术中失血量比对照组少,但透视次数比对照组多,差异有统计学意义(P<0.05)。结论对SFH患儿采取切开复位或闭合复位结合克氏针固定的治疗方案均可获取到相对满意的临床治疗效果与安全性。闭合复位方案能缩短手术及术后康复的时间,减少术中失血量,建议优先进行考虑。

Objective To analyze the clinical efficacy of open reduction and closed reduction combined with Kirschner wire fixation in children with supracondylar fracture of humerus(SFH).Methods 56 SFH children admitted to the Department of the First People's Hospital of Tianshui City from May 2020 to May 2022 were selected as study subjects,and they were grouped according to the surgical program,with 28 cases in each group.The control group carried out the treatment method of incision repositioning+Kirschner's pin fixation,and the observation group adopted the program of closed repositioning+Kirschner's pin fixation,and compared the clinical excellence rate,clinical general observation indexes,and the occurrence of postoperative complications between the two groups.Results There was no statistically significant difference in the comparison of clinical excellence rate,fracture healing time and postoperative complication rate between the two groups(P>0.05).The operation time[(48.92±18.99)min]and hospitalization time[(4.08±1.85)d]of the observation group were all shorter than those of the control group[(98.65±29.45)min,(8.12±3.65)d],and the differences were statistically significant(t=7.510,5.224,P<0.05).Intraoperative blood loss in the observation group was less than that in the control group,but the number of fluoroscopies was more than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Open reduction or closed reduction combined with Kirschner wire fixation can achieve relatively satisfactory clinical therapeutic effects and safety for children with SFH.The closed repositioning option reduces the duration of surgery and postoperative recovery,reduces intraoperative blood loss,and is recommended to be prioritized.