[Comparison of clinical effects of various external fixation for the treatment of humeral supracondylar fracture]

Abstract

Objective: To compare clinical effects and the incidence rates of cubitus varus in displaced humeral supracondylar fractures treated with different kinds of external fixation.

Methods: 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.

Results: 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.

Conclusion: 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.