A retrospective comparative study of open reduction and cannulated screw fixation and Kirschner wire fixation in the treatment of fracture of lateral condyle of humerus in children

Abstract

Objective To evaluate the clinical efficacy of two surgical methods in the treatment of fracture of lateral condyle of humerus in children and the application value of two kinds of internal fixation materials.Methods A total of 32 children with fracture of lateral condyle of humerus were treated in our hospital from June 2015 to June 2018, with an average age of 5.6 years, including 18 males and 14 females. The patients were divided into two groups: group A (n = 12) and group B (n = 20). By comparing the operation time, removal of internal fixation time, Dhillon elbow function evaluation, HHS elbow function score, X-ray measurement of postoperative carrying angle, Baumann angle and distal humerus anteversion angle, the operation-related complications were recorded in detail.Results The operation time was 0.9 ±0.2 hours in group A, 0.8 ±0.2 hours in group B, P > 0.05. The removal internal fixation time was 91 ±8 days in group A, 59 ±10 days in group B (P < 0.05). The Dhillon elbow function score was 8.2 ±0.6 in group A, 8.0 ±0.8 in group B, and 93 ±5 in group A and 89 ±4 in group B (P > 0.05). The carrying angle was 10 °±1 °in group A and 10 °±2 °in group B (P > 0.05). The Baumann angle was 15 °±4 °in group A and 16 °±3 °in group B (P > 0.05). The anteversion of distal humerus was 33 °±3 °in group A and 33 °±4 °in group B (P > 0.05). In the last follow-up, the excellent and good rate of elbow joint function in group A was excellent in 8 cases and good in 4 cases, and the excellent and good rate in group B was 100%. In group B, 13 cases were excellent, 6 cases were good, and 1 case was moderate, with an excellent and good rate of 95%. The postoperative complications were observed in group A, including avascular necrosis of lateral condyle in 1 case, premature closure of epiphysis in 1 case, skin irritation in 5 cases, needle exudation and incision infection in 2 cases, hyperplasia of lateral condyle in 3 cases, and loss of extension and flexion in 1 case.Conclusions There was no significant difference in operation time, elbow function recovery and imaging measurement between the two surgical methods in the treatment of lateral condylar fracture of humerus. Kirschner wire group had a certain advantage over cannulated cancellus screw group in fracture healing and removal of internal fixation. however, the clinical observation screw group has advantages in postoperative nursing and early exercise.

Cannulated Screw Versus Kirschner Wire Fixation Following Open Reduction of Lateral Condyle Fracture of Humerus

“…In the retrospective comparative study of Luo et al [19] Baumann angle was 15 (±4 ) with screw fixation and 16 (±3 ) in the K-wire group. The authors concluded that there was no significant difference between two groups (p = > 0.05).…”