[Treatment of humeral shaft fractures in children with closed reduction and external fixation].

OBJECTIVE: To explore the clinical effect of closed reduction and minimally invasive treatment of humeral shaft fractures in children.

METHODS: From July 2011 to April 2015, 39 cases of pediatric humeral shaft fractures were treated by closed reduction and external fixation, including 27 males and 12 females with a mean age of 8.6 years old ranging from 3 to 14 years old. Time from injury to the treatment was 2 h to 7 days with an average of 2.7 days. There were 6 cases of upper fracture, 21 cases of middle fracture and 12 cases of lower fracture. All children were closed injury, appeared pain, swelling, local deformity and limited mobility and other symptoms after injury. X-ray examination showed humeral shaft fracture. Neer score of shoulder joint function and HSS score of elbow joint function were used to record and analyze the pain, function and activity of shoulder and elbow joint before and after treatment.

RESULTS: All the 39 cases were followed up for 6 to 12 months with a mean of 8.6 months. Two cases appeared postoperative superficial infection of the needle, and healed after dress; other cases gained good pinhole healing. There were significant differences in the pain, function and activity of the shoulder of Neer score before and after the treatment ( P <0.05). There were significant differences in the pain and function of the elbow of HSS before and after treatment ( P <0.05). According to the evaluation of Neer score of shoulder function, the total score was 88.82±2.50, 29 cases were excellent, 9 cases were good, and 1 case was fair. According to the evaluation of HSS score of elbow joint function evaluation, the total score was 91.51±5.09, 30 cases were excellent, 7 cases were good, 2 cases were general.

CONCLUSIONS: Manual closed reduction combined with external fixation for the treatment of humeral shaft fractures in children has advantages of less trauma, definite reduction effect, reliable fixation and benefit for early functional exercise of the shoulder and elbow joint. This therapy can be used as one of clinical methods for the treatment of humeral shaft fractures in children.