Surgical treatment for 197 children with distal humerus epiphysiolysis fracture

Abstract:

Objective：To analyze the characteristics and key diagnosis points of children humerus distal epiphysiolysis fracture；to study the surgical treatment methods，significance and related issues. Methods：From 2004-2012，197 children with distal humerus epiphysiolysis were received and cured. According to the Delee standards：there were 5 cases of type A，138 cases of type B and 54 cases of type C. Totally 115 cases were cured within 24 h after the injury，69 cases were cured within 1-7 d and 13 cases were cured over 7 d. All children were operated by open reduction and internal fixation through the anterior elbow approach. X-ray was performed after surgery within 24 h. Kirschner wire was removed and excises were started within 4-6 weeks. Results：Totally 197 children were followed up for 6 months to 2 years with an average of 15 months. Kirschner wire was removed within 4-5 weeks with an average of 5 weeks. According to the Flynn standards，elbow function was evaluated：179 cases were excellent，11 cases were good，4 cases were fair，3 cases were bad and the excellent and good rate was 96.4%. Children underwent surgery within 7 d had higher excellent and good rate than those underwent surgery over 7 d，with statistical difference between two groups（P<0.05）. Conclusion：Treating child humerus distal epiphysiolysis fracture through anterior elbow approach is easy to perform. The fracture can be easily restored and the restored fracture can be anatomized. It can reduce the incidence of cubitus varus and cubitus valgus and retain limb function to the greatest extent.