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| Analysis of the clinical diagnosis and treatment of humeral supracondylar fracture with brachial artery injury in children |
| LIU Peng1 ZHU Shu2 LIU Lie1 XIAO Wenjie1 SONG Ningya1 GONG Wei1 |
1.Department of Orthopedics, Baoji Central Hospital, Shaanxi Province, Baoji 721008, China;
2.Department of Orthopedics, Air Force General Hospital, Beijing 100142, China |
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Abstract Objective To explore the clinical experience of diagnosis and treatment of Gartland Ⅲ on the humerus condyle fracture merge brachial artery injuries in children. Methods From August 2016 to August 2018, 52 cases of Gartland type Ⅲ humerus condyle fracture merge brachial artery injury of children admitted in Baoji Central Hospital in Shaanxi Province were selected. These included 40 children with closed fractures and 12 children with open fractures. The former adopted the method of lateral approach of elbow, the fracture was fixed first, then local hot compress was done, and finally local injection of Papaverine. The latter first debridement, then upper and lower extension of the wound, the broken end of brachial artery was freed, anastomosis, and then fracture reduction and fixation were carried out. Finally with 2-3 kirschner wire cross fixation. The treatment effects of children of the two groups were compared, and Logistic regression analysis was used to analyze the factors affecting the recovery of the children. Results All the 52 cases of fracture healed well, and the recovery rate of elbow joint motion function was 100%. No related complications occurred in the two groups. Logistic multivariate regression analysis showed that the factors affecting the postoperative functional recovery of children with humeral supracondylar fracture included injury to operation time＞ 48 h, postoperative functional exercise time delay and low compliance with medical advice after discharge (P ＜ 0.05). Conclusion The main factors affecting the postoperative functional recovery of children with supracondylar fracture of humerus included injury to operation time, postoperative functional exercise time and discharge compliance. Patients with suspected vascular injury should be carefully continuous dynamic observated, early surgical treatment should be adopt once diagnosed.
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