中文摘要：

目的：评价闭合复位经皮克氏针内固定术与切开复位克氏针内固定术治疗儿童GarlandⅡ、Ⅲ型肱骨髁上骨折（supracondylar fracture of humerus,SCHF）的疗效和安全性。方法：通过计算机检索Medline、Pub Med、The Cochrane Library（2015年第10期）、CBM、CNKI、Wan Fang Data、VIP建库至2015年10月国内外公开发表的所有闭合复位经皮克氏针内固定术与切开复位克氏针内固定术治疗儿童GarlandⅡ、Ⅲ型SCHF的随机对照试验或半随机对照试验文献,同时手工检索本专业相关期刊从创刊至2015年10月的所有相关文献。由2位检索员独立筛选文献、提取资料、依据Cochrane系统进行文献方法学质量评价后,采用Rev Man5.2软件进行Meta分析。结果：共检索出相关文献559篇,最终纳入14篇文献,仅1篇文献为随机对照试验,其余均为半随机对照试验;共涉及917例患者,其中闭合复位组471例、切开复位组446例。Meta分析结果显示,闭合复位组与切开复位组在术后Flynn肘关节功能优良率、肘关节屈伸活动度及手术时间方面比较,组间差异均无统计学意义[OR=1.460,95%CI（0.95,2.25）,Z=1.750,P=0.080;MD=0.570,95%CI（-8.69,9.83）,Z=0.120,P=0.900;MD=-6.350,95%CI（-64.07,51.37）,Z=0.220,P=0.830];在术后发生肘内翻、针道或切口感染、尺神经损伤及骨化性肌炎方面比较,组间差异均无统计学意义[OR=0.870,95%CI（0.35,2.20）,Z=0.290,P=0.770;OR=0.620,95%CI（0.31,1.21）,Z=1.400,P=0.160;OR=1.980,95%CI（0.88,4.49）,Z=1.640,P=0.100;OR=0.150,95%CI（0.02,1.39）,Z=1.670,P=0.100]。结论：对于儿童GarlandⅡ、Ⅲ型SCHF,闭合复位经皮克氏针内固定术与切开复位克氏针内固定术在临床疗效、安全性、手术时间方面均无明显差异,这可能与本研究所纳入的符合条件的文献数量较少及其方法学质量普遍偏低有关。

英文摘要：

Objective：To evaluate the curative effect and safety of closed reduction and percutaneous internal fixation with Kirschner wire versus open reduction and internal fixation with Kirschner wire for treatment of Gartland type Ⅱ and Ⅲ supracondylar fractures of humerus（SCHF） in children. Methods：All the randomized controlled trial（RCT） articles and controlled clinical trial（CCT） articles about closed reduction and percutaneous internal fixation with Kirschner wire versus open reduction and internal fixation with Kirschner wire for treatment of Gartland type Ⅱ and Ⅲ SCHF in children that pubiished at home and abroad included from database establishing to October 2015 were retrieved from Medline,PubMed,the Cochrane Library （2015, No. 10）, CBM, China national knowledge internet, WanFang Database and VIP Database through computer. Meanwhile, all the relevant articles published in relevant orthopedic journals included from journal establishing to October 2015 were manual retrieved. The articles were screened and the information was extracted independently by two searchers. The methodological quality of research in the articles was evaluated by using Cochrane system and a Meta - analysis was conducted by using Revmau 5.2 software. Results ： Five hundred and fifty - nine articles were searched out. After screening, 14 trials （ 917 patients） were includ- ed in the final analysis ,including one RCT and 13 CCT ,471 patients in closed reduction group and 446 patients in open reduction group. The result of Meta - analysis demonstrated that there was no statistical difference in postoperative Flynn elbow joint function, postoperative flexion - extension range of elbow joint and operative time between the 2 groups [ OR = 1. 460,95 % CI（0. 95,2.25 ） , Z = 1. 750, P = 0.080; MD =0.570,95%CI（-8.69,9.83） ,Z =0. 120,P =0. 900;MD = -6. 350,95% CI（-64.07,51.37） ,Z =0. 220,P = 0. 830] ,and there was no statistical difference in the incidence rate of postoperative complications including cubitu