闭合复位经皮克氏针内固定在不同时机治疗儿童肱骨髁上骨折的效果及并发症比较

doi:10.3969/j.issn.1006-5725.2026.04.016

Abstract

Abstract:

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.

Key words: humeral supracondylar fracture, child, closed reduction and percutaneous pinning, surgical timing, elbow function, complication

CLC Number:

R726.8

Shaosong SUN,Shaoyu ZHU,Xingchen ZHANG,Bin DENG. Comparison on the effect and complications of different timing of CRPP in the treatment of children with humeral supracondylar fractures[J]. The Journal of Practical Medicine, 2026, 42(4): 655-662.

Figures/Tables 9

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References 27

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项目	早期组（n = 58）	延期组（n = 42）	t/χ2值	P值
性别			1.751	0.186
男	34（58.62）	19（45.24）
女	24（41.38）	23（54.76）
年龄（x ± s）/岁	6.82 ± 1.31	7.21 ± 1.19	1.526	0.130
骨折患侧（左/右）			0.164	0.685
左	30（51.72）	20（47.62）
右	28（48.28）	22（52.38）
Gartland分型			0.365	0.546
Ⅱ型	31（53.45）	25（59.52）
Ⅲ型	27（46.55）	17（40.48）
受伤原因			1.451	0.694
摔伤	19（32.76）	14（33.33）
运动伤	21（36.21）	11（26.19）
交通事故	12（20.69）	12（28.57）
其他	6（10.34）	5（11.90）
受伤至手术时间（x ± s）/h	8.26 ± 1.35	17.53 ± 2.64	22.946	< 0.001

指标	早期组（n = 58）	延期组（n = 42）	t/Z值	P值
手术时间/min	35.61 ± 4.27	46.32 ± 4.58	12.031	< 0.001
术中出血量/mL	6.29 ± 1.05	8.46 ± 1.36	9.003	< 0.001
术中透视次数［M（P₂₅，P₇₅）］/次	5（4，6）	7（6，9）	6.842	< 0.001
住院时间/d	3.80 ± 0.82	4.12 ± 1.14	1.633	0.106
骨折愈合时间/周	5.38 ± 1.16	5.67 ± 1.25	1.194	0.235

组别	肘关节活动度	Baumann角	提携角
早期组（n = 58）	142.61 ± 12.35	70.18 ± 4.21	13.75 ± 2.07
延期组（n = 42）	139.24 ± 10.17	71.56 ± 3.42	12.07 ± 2.42
t值	1.448	1.747	1.510
P值	0.151	0.084	0.134

组别	优	良	可	差	优良率
早期组（n = 58）	21（36.21）	16（27.59）	18（31.03）	3（5.17）	94.83
延期组（n = 42）	12（28.57）	13（30.95）	9（21.43）	8（19.05）	80.95
χ2值					4.790
P值					0.029

组别	针道感染	肘内翻畸形	医源性神经损伤	总发生率/%
早期组（n = 58）	2（3.45）	3（5.17）	1（1.72）	10.34
延期组（n = 42）	4（9.52）	9（21.43）	3（7.14）	38.10
χ2值	-	6.06	-	10.932
P/FisherP值	0.235	0.014	0.307	0.001

Comparison on the effect and complications of different timing of CRPP in the treatment of children with humeral supracondylar fractures

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因素	β	SE	Wald χ²	OR	95%CI	P值
手术时机	0.875	0.420	4.340	2.399	1.053 ~ 5.464	0.038
手术时间	-0.917	0.406	5.101	0.400	0.180 ~ 0.886	0.024
术中出血量	-1.293	0.611	4.478	0.274	0.083 ~ 0.909	0.035
术中透视次数	-1.146	0.503	5.191	0.318	0.119 ~ 0.852	0.023
性别	0.674	0.421	2.563	1.962	0.860 ~ 4.478	0.110
年龄	0.723	0.418	2.992	2.061	0.908 ~ 4.675	0.084
骨折患侧	0.638	0.522	1.494	1.893	0.680 ~ 5.265	0.222
Gartland分型	0.804	0.497	2.617	2.234	0.844 ~ 5.919	0.106
受伤至手术时间	0.751	0.414	3.291	2.119	0.941 ~ 4.770	0.070

因素	β	SE	Wald χ²	OR	95%CI	P值
手术时机	1.264	0.593	4.543	3.540	1.107 ~ 11.317	0.034
手术时间	-0.741	0.469	2.496	0.477	0.190 ~ 1.195	0.115
术中出血量	-0.859	0.543	2.503	0.424	0.146 ~ 1.228	0.114
术中透视次数	-0.928	0.561	2.736	0.395	0.132 ~ 1.187	0.099

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