Observation on the therapeutic effect of two Kirschner wire fixation methods under ultrasound guidance in the treatment of supracondylar fractures of humerus in children

Objective To compare the clinical efficacy between ultrasound-guided closed reduction with Kirschner wire for medial and lateral cross fixation and simple lateral fixation in the treatment of extended supracondylar fractures of humerus in children.

Methods A retrospective analysis was conducted on 84 children with extended supracondylar fractures of humerus (Gartland types Ⅱ-Ⅳ). They were divided into the closed reduction internal and external cross fixation group (group A) and simple lateral fixation group (group B) according to the surgical methods. The operation time, hospital stay, fracture healing time, elbow joint function score and delayed ulnar nerve injury, rate of fracture re-displacement and postoperative complications were compared between two groups.

Results All children were followed up. The average follow-up time in group A and group B were (10.31 ± 3.24) months and (10.06 ± 3.78) months, respectively. The operation time in group A was (33.84 ± 3.23) min, which was longer than that of group B (28.68 ± 3.45) min, and the difference was statistically significant (P ＜ 0.01). The fracture healing time in two groups were (37.23 ± 7.38) days and (35.67 ± 6.83) days, respectively, and there was no statistically significant difference between two groups (P ＞ 0.05). In group A, there were 2 cases of delayed ulnar nerve injury and 3 cases of other complications. In group B, no ulnar nerve injury occurred, but 2 cases of other complications. There was no statistically significant difference in the incidence of postoperative complications between two groups (P ＞ 0.05). Neither of the two groups of children had the occurrence of cubitus varus or cubitus valgus. There was no statistically significant difference in the elbow joint function and related indicators between two groups after 8 months of operation (P ＞ 0.05).

Conclusions Both ultrasound-guided closed reduction with Keshler wire for medial and lateral cross fixation and simple lateral fixation are effective fixation methods for supracondylar fractures of humerus in children. Among them, the medial and lateral cross fixation can reduce the possibility of postoperative fracture displacement, but it may cause delayed ulnar nerve injury.