目的 探讨不同时机闭合复位经皮克氏针内固定（CRPP）治疗儿童肱骨髁上骨折的临床疗效及对并发症的影响。 方法 回顾性研究，选取2022年2月至2025年2月徐州医科大学附属医院收治的肱骨髁上骨折患儿100例，所有患儿均接受CRPP治疗，根据受伤至手术时间分为早期组（≤ 12 h，n = 58）和延期组（> 12 h，n = 42）。对比两组围术期相关指标、骨折愈合时间；于术后3个月评估患儿患侧肘关节活动度、Baumann角、提携角，并采用Flynn肘关节评分标准评估临床疗效，记录并发症发生率。 结果 早期组手术时间、术中出血量及术中透视次数均短（少）于延期组（P < 0.05），但两组住院时间和骨折愈合时间对比无差异（P > 0.05）；术后3个月，两组肘关节活动度及Baumann角、提携角对比差异均无统计学意义（P > 0.05）。早期组优良率高于延期组（94.83% vs. 80.95%）（P < 0.05）。早期组肘内翻畸形发生率及总并发症发生率均低于延期组（P < 0.05）。单因素logistic回归分析，结果显示，手术时机、手术时间、术中出血量、术中透视次数均与儿童肱骨髁上骨折CRPP治疗后疗效有关（P < 0.05）。多因素logistic回归分析显示，早期手术是影响儿童肱骨髁上骨折 CRPP 治疗后疗效优良的独立保护因素（P < 0.05）。 结论 与延期手术相比，早期（受伤至手术时间≤ 12 h）行CRPP治疗肱骨髁上骨折患儿，可显著缩短手术时间，减少术中出血量，提升肘关节功能优良率，并降低并发症风险。

Objective To explore the clinical curative effect of different timings of closed reduction and percutaneous pinning （CRPP） and its influences on complications in children with humeral supracondylar fractures. Methods In this retrospective study， a total of 100 children with humeral supracondylar fractures who underwent CRPP at the Affiliated Hospital of Xuzhou Medical University between February 2022 and February 2025 were enrolled. Based on the interval from injury to surgery， the children were divided into an early-treatment group （interval ≤ 12 hours， n = 58） and a delayed-treatment group （interval > 12 hours， n = 42）. The perioperative indexes and fracture healing time were compared between the two groups. Three months after surgery， the elbow range of motion on the affected side， Baumann angle， and carrying angle were evaluated. The clinical curative effect was assessed using the Flynn elbow scoring standard， and the incidence of complications was recorded. Results The operation time， intraoperative blood loss， and intraoperative fluoroscopy frequency in the early group were all significantly shorter or less than those in the delayed group （P < 0.05）. However， there was no significant difference in the length of hospital stay or fracture healing time between the two groups （P > 0.05）. Three months after surgery， there was no significant difference in the elbow range of motion， Baumann angle， or carrying angle between the two groups （P > 0.05）. The good-outcome rate of the early group was significantly higher than that of the delayed group （94.83% vs. 80.95%， P < 0.05）. The incidence of cubitus varus and the total incidence of complications in the early group were significantly lower than those in the delayed group （P < 0.05）. The results of univariate logistic regression analysis indicated that surgical timing， operation time， intraoperative blood loss， and intraoperative fluoroscopy frequency were all associated with the curative effect in children with humeral supracondylar fractures following CRPP （P < 0.05）. Multivariate logistic regression analysis demonstrated that early surgery was an independent protective factor for a good curative effect in children with humeral supracondylar fractures after CRPP （P < 0.05）. Conclusion Compared with delayed surgery， early CRPP （interval from injury to surgery ≤ 12 h） can significantly shorten the operation time， reduce the intraoperative blood loss， increase the good rate of elbow function， and reduce the risk of complications in children with humeral supracondylar fractures.