中文摘要：

目的：探讨GartlandⅢ型肱骨髁上骨折手法复位小夹板外固定治疗后残存单纯前后移位对预后的影响。方法：收集2009年1月至2016年3月采用杨氏四步复位手法治疗后，残存断端前后移位的85例新鲜闭合GartlandⅢ型肱骨髁上骨折患者的病例资料。在治疗后肘关节侧位X线片上，将肱骨近端横径分成3等份，分别过2个等分点垂直于肱骨近端横径做垂线。按照移位方向将前后移位分为A型（向后移位）和B型（向前移位）2类，再分别按照远折端前缘和后缘相对于2条垂线的位置将其进一步分为AⅠ型（远折端前缘位于第1条垂线前方）、AⅡ型（远折端前缘位于2条垂线之间）、AⅢ型（远折端前缘位于第2条垂线后方）、BⅠ型（远折端后缘位于第2条垂线后方）、BⅡ型（远折端后缘位于2条垂线之间）、BⅢ型（远折端后缘位于第1条垂线前方）。记录患者的骨折愈合时间、治疗后即刻和治疗后12个月时的Baumann角，以及治疗后3个月和12个月采用Flynm标准评定的肘关节功能。结果：失访5例；80例患者获得随访，随访时间12～24个月，中位数14个月。AⅠ型35例、AⅡ型18例、AⅢ型5例、BⅠ型11例、BⅡ型8例、BⅢ型3例。所有患者的骨折均在1个月内达到临床愈合标准，6种前后移位类型患者的骨折愈合时间比较，差异无统计学意义[（28．53±1．25）min，（29．01±1．19）min，（29．19±1．50）min，（28．91±1．30）min，（29．05±1．24）min，（29．31±1．17）min，F=0．420，P=0．671]。治疗后即刻及治疗后12个月时所有患者的Baumann角均在正常范围内，至随访结束时所有患者均未发生肘内翻；治疗后即刻及治疗后12个月时6种前后移位类型患者的Baumann角比较，组间差异无统计学意义（74．04°±4．40°，73．09°±4．69°，73．01°±4．26°，72．98°±4．32°，73．14°±3．90°，72．93°±4．06°，F=0．26

英文摘要：

Objective ：To explore the effect of posttreatment residual simple anterior - posterior displacement of broken end of fractured bone on prognosis in patients who receive manipulative reduction and small splint external fixation for Gartland type Ⅲ humeral supracondy- lar fractures. Methods ： The medical records of 85 patients with residual anterior - posterior displacement of broken end of fractured bone af- ter treatment of fresh closed Gartland type Ⅲ humeral supraeondylar fracture with Yang＇ s four - step reduction manipulation from January 2009 to March 2016 were collected. The transverse diameter of proximal humerus was divided into 3 equal parts on the posttreatment lateral X-ray films of elbow joint. Two lines were drawn through the 2 equation points respectively and they crossed the transverse diameter of proxi- mal humerus at right angles. The anterior - posterior displacement of broken end of fractured bone was divided into type A （ retrodisplace- ment） and B （antedisplaeement）based on the displacement direction, and was subdivided into type A I （the anterior border of distal broken end was in front of the first perpendicular line ） , A Ⅱ （ the anterior border of distal broken end was located between the 2 perpendicular lines） , A Ⅲ[（ the anterior border of distal broken end was behind the second perpendicular line） , B Ⅰ （the posterior border of distal broken end was behind the second perpendicular line） , BⅡ （ the posterior border of distal broken end was located between the 2 perpendicular lines） and B Ⅲ（ the posterior border of distal broken end was in front of the first perpendicular line） based on the location of anterior border and posterior border of distal broken end relative to the 2 perpendicular lines respectively. Fracture healing time, Baumann angles measured immediately post - treatment and at 12 months after the treatment and the elbow joint function evaluated by using Flynm standard at 3 and 12 months after the treatment were recorded r