To compare the presentation and postoperative results of children treated for open and Gartland type Ⅲ supracondylar fractures of the humerus.

From June 2011 to June 2019, 19 patients with open and 38 patients with Gartland type Ⅲ supracondylar fractures of the humerus were evaluated. Intravenous antibiotics were used for open supracondylar fracture patients as early as possible. Patients with Gustilo types Ⅲ and Ⅱ open supracondylar fracture of the humerus were treated by emergency operation. Gustilo type Ⅰ open supracondylar fracture patients were treated by disinfection, bandage, reduction, temporary plaster fixation, emergency or sub emergency operation. Gartland type Ⅲ supracondylar fracture patients were treated by reduction, temporary plaster fixation, and operation within the time limit. The wound characteristics, combined injuries, operation timing, operation time, clinical efficacy, and complications were analyzed.

The two groups were similar with respect to age and sex. All the patients were followed for 6-27 months, with an average of 19 months. The mean operative time of Gustilo type Ⅰ patients was (35.18±4.67) min, and that of Gartland type Ⅲ patients was (40.77±2.68) min; the difference between them was not statistically significant (P=0.273). The mean operative time of Gustilo type Ⅱ patients was (41.25±5.15) min, which was longer than that of Gartland type Ⅲ patients, but with no statistically significant difference (P=0.063). The mean operative time of Gustilo type Ⅲ patients was (200.00±61.64) min, which was longer than that of Gartland type Ⅲ patients (P=0.037). The incidence of postoperative infection was 5.3% in open fracture patients and 2.6% in Gartland type Ⅲ patients, and the difference between them was not statistically significant (χ²=0.259, P=0.611). The incidence of nerve injury was 28.9% in Gartland type Ⅲ patients and 42.1% in open fracture patients, and there was no significant difference between them (χ²=0.987, P=0.321). At the last follow-up, 36 cases (94.7%) achieved excellent results and 2 cases (5.3%) achieved good results in Gartland type Ⅲ patients and the corresponding figures in open fracture patients were 16 (84.2%) and 3 (15.8%), respectively, there was no significant difference between them (χ²=1.754, P=0.185).

Open supracondylar fracture of the humerus in children can be cured with antibiotics, timely debridement, and effective fixation. The treatment effect of open supracondylar fractures of the humerus in children is similar to that of Gartland type Ⅲ supracondylar fractures. The therapeutic effect is excellent.