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目的:比较内外侧交叉进针（MLP）与单纯外侧进针（LP）克氏针内固定治疗儿童Gartland Ⅱ和Ⅲ型肱骨髁上骨折的疗效。方法:依据PRISMA步骤，检索1990年1月1日至2020年1月1日PubMed（Medline）、EMBASE、the Cochrane Library databases（Cochrane Controlled Trials Register for RCTs）和万方数据库等，筛选纳入关于儿童肱骨髁上骨折的随机临床研究（RCT）。2位研究者独立提取数据，并评估原始研究质量；采用随机效应模型进行分析。结果:共检索到4 679篇原始文献，最终纳入11篇文献，920例患儿。Meta分析结果显示，MLP组与LP组患儿肘关节功能优（Flynn标准）比例、医源性神经损伤发生率和针道/浅表感染发生率比较差异无统计学意义[74.3%（255/343）比72.9%（250/343）、6.1%（16/262）比1.6%（4/246）和5.3%（14/264）比7.6%（20/262），n RR = 0.98、0.43和1.31，95% n CI 0.90~1.07、0.18~1.03和0.64~2.67，n P > 0.05]；MLP组复位丢失发生率明显低于LP组[16.6%（51/307）比23.9%（72/301）]，差异有统计学意义（n RR = 1.39，95% n CI 1.02~1.89，n P = 0.04）。n 结论:MLP内固定和LP内固定对Gartland Ⅱ和Ⅲ型儿童肱骨髁上骨折同样有效。MLP内固定可降低复位丢失的风险，而不明显增加医源性神经损伤的风险。推荐使用手法复位经皮MLP内固定治疗移位明显的儿童肱骨髁上骨折。“,”Objective:To compare the safety and efficacy of medial-lateral pinning (MLP) and lateral pinning (LP) in pediatric supracondylar humeral fractures.Methods:According to PRISMA procedure, the randomized controlled trial (RCT) of pediatric supracondylar humeral fractures in PubMed (Medline), EMBASE, the Cochrane Library databases (Cochrane Controlled Trials Register for RCTs) and Wanfang Data from 1 January, 1990 to 1 January, 2020 were retrieved. Two researchers independently extracted the data and evaluated the quality of the original studies; the random-effects model was used for analysis.Results:A total of 4 679 original literatures were retrieved and 11 literatures were finally included, involving 920 children. Meta analysis results showed that there were no statistical differences in excellent ratio of elbow joint function (Flynn criteria), incidence of iatrogenic nerve injury and incidence of pin tract/ superficial infection between MLP group and LP group: 74.3% (255/343) vs. 72.9% (250/343), 6.1% (16/262) vs. 1.6% (4/246) and 5.3% (14/264) vs. 7.6% (20/262); n RR = 0.98, 0.43 and 1.31; 95% n CI 0.90 to 1.07, 0.18 to 1.03 and 0.64 to 2.67, n P>0.05; the incidence of reduction loss in MLP group was significantly lower than that in LP group: 16.6% (51/307) vs. 23.9% (72/301), and there was statistical difference (n RR = 1.39, 95% n CI 1.02 to 1.89, n P = 0.04).n Conclusions:MLP fixation and LP fixation are equally efficacious for supracondylar humeral fractures in children. MLP fixation may reduce the risk of reduction loss without increasing the risk of iatrogenic nerve injury. Manual reduction and MLP percutaneous Kirschner wire fixation for the treatment of displaced supracondylar humeral fractures in children is recommended.