Jiang Peng,Chen Wuping,Lin Hongwang,et al.Comparison of conservative and surgical treatment for Gartland type Ⅱ supracondylar humeral fracture in children[J].Journal of Clinical Pediatric Surgery,,20():646-651.[doi:10.12260/lcxewkzz.2021.07.010]
Comparison of conservative and surgical treatment for Gartland type Ⅱ supracondylar humeral fracture in children
- Keywords:
- Humeral Fractures/SU; Supracondy larhumeral fractures; Gartlandtype Ⅱ; Fracture Fixation; Conservative Treatment; Treatment Outcome
- CLC:
- R726.834.13;R687.3
- Abstract:
- Objective To compare the outcomes of conservative treatment versus surgery for Gartland type Ⅱ supracondylar humeral fracture in children.Methods Retrospective review was conducted for clinical data of 41 children with Gartland type Ⅱ supracondylar humeral fracture from January 2015 to December 2018.Their mean age was (5.4±2.2) years.According to therapeutic modality,they were divided into two groups of conservative treatment (A,n=17) and surgery (B,n=24).No significant inter-group differences existed in age,gender,sideness or follow-up time.During the final follow-up visit,the elbow angles were measured,including hyperextension angle,flexion angle,range of motion (ROM) and clinical carrying angle.And Baumann angle was measured on anterior-posterior (AP) radiograph.Additionally,anterior humeral line (AHL),bisecting the middle third of humeral capitellum on lateral radiograph,was also evaluated.Function of elbow joint was scored by the Quick Disabilities of Arm,Shoulder and Elbow (QuickDASH) and the Flynn grading criteria of elbow clinical function.Results During the final follow-up visit,hyperextension angle,flexion angle,ROM,clinical carrying angle and Baumann angle were (9.1±6.6)°,(139.2±6.7)°,(152±6.3)°,(8.4±5.9)° and (77.6±5.8)° respectively.No significant inter-group differences existed in these angles.For 11 children in group A (64.7%),the line of AHL passed through the middle third of capitellum (n=11,64.7%) and it was significantly less than that in group B (n=22,91.7%) (P=0.049).The total QuickDASH score was (1.5±2.1) and there was no inter-group difference.According to the Flynn criteria,the rate of excellent & good was 94.1%(16/17) in group A and 91.7%(22/24) in group B.There was no inter-group difference.In group A,one child (n=1,5.9%) developed cubitus varus.In group B,there were the complications of cubitus varus (n=1,4.2%),ulnar nerve injury (n=1,4.2%) and pin tract infection (n=1,4.2%).Conclusion Both conservative treatment and surgery can achieve excellent cosmetic and clinical outcomes in children with Gartland type Ⅱ supracondylar humeral fractures.Surgery offers better radiographic outcomes while conservative treatment has a lower rate of complications.
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收稿日期:2020-12-05。
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