操纵杆辅助闭合复位治疗儿童不可复性肱骨髁上骨折

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Abstract Objective To investigate the safety and efficacy of joystick-assisted closed reduction in the treatment of the irreducible humerus supracondylar fracture.Methods Between January 2016 and October 2018，we collected 645 casesof Gartland type Ⅲ humerus condyle fracture in our hospital，including 32 casesof irreducible supracondylar fracture of humerus，14 cases of themunderwent successful close“milking”reduction，whilethe remaining 18 fractures were reducted sucessfully with joystick-assisted method.2 cases were lost during follow-up，and a total of 16 cases completed the follow-up.There were 12 males and 4 females.The ages between the children are 3 to 12 years old，the mean age was (7.31±2.44)years.There were 7 cases of preoperative median nerve symptoms and 4 cases of disappearance of radial pulse.Postoperative X-ray film was recorded.The Baumann angle and carrying angle were measured in the last follow-up and compared with the Control side.Flynn elbow joint function score was used for functional evaluation in the last follow-up.Results The shpiro-wilk normality test was conducted for the Baumann Angle on the healthy side and the injured side after surgery.The results indicated that the Baumann Angle on the healthy side was in line with the normal distribution (P＝0.37，P＝0.64 after surgery).The parametric paired t-test was performed (P＝0.17).There was no significant statistical difference between the healthy side and the postoperative Baumann Angle.By the same method，statistical test was conducted for the lifting Angle of the healthy side and the injured side (P＝1.00)，and there was no significant difference between the carrying angle and the healthy side.The score of Flynn elbow joint function was excellent in 9 cases，good in 6 cases，and good in 1 case，accounting for 93.75%.Conclusion The “joystick-assisted” closed reduction technique at the posterior side of triceps humerus can be used as an effective supplement and auxiliary method for the reduction of closed reduction and “irreducible” supracondylar fracture of humerus，which has been proved to be safe and effective in early clinical studies.

Key words： joystick closed reduction irreducible supracondylar fracture of humerus

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