Clinical and Radiographic Evaluation of the Operative Treatment of Lateral Humeral Condylar Fracture in Children at Shafa Hospital, Tehran, Iran

Abstract

Background: The goal of treatment in displaced lateral condylar fracture is to achieve union without residual deformity. However, growth disturbance may occur despite initial anatomic reduction and secure fixation. Objectives: The purpose of this study was to evaluate clinical and radiographic results and assess complications associated with the operative treatment of lateral condylar fractures in children. Methods: A total of 73 pediatric patients under the age of 13 years, who were diagnosed with displaced lateral condylar fractures of the humerus and were treated with open reduction and internal fixation, were assessed from March 2011 to September 2015. The mean follow-up duration in these patients was 22 months (8 -48 months). The clinical results were evaluated using the Hardcare scoring system. Also, anteroposterior and lateral radiographic views were assessed to identify the union process and presence of complications. Results:The results of evaluation on 48 boys and 25 girls demonstrated that lateral condylar fractures of the humerus were more common in boys, aged 5-8 years (average: 57.1%). There was no significant relationship between complications and sex. However, according to the radiographic evaluation, while fractures in 71 (97.2%) patients were completely united without any complications, 2 (2.8%) patients experienced overgrowth of the lateral humeral condyle. Clinical evaluation demonstrated excellent and good outcomes in 68 and 5 patients, respectively. Also, evaluation of Hardcare scores revealed no significant relationship between complications and clinical outcomes. Conclusions:The present results were in line with previous research regarding the absence of complications such as non-union, avascular necrosis, fishtail deformity, cubitus varus, cubitus valgus, and pain. The findings demonstrated that the acceptable treatment option for displaced and rotated fractures is open reduction and internal fixation. Furthermore, deformity did not affect the clinical outcomes of fractures.

Clinical and Radiological Results of Open Reduction and Internal Fixation for the Treatment of Lately Presented Lateral Humeral Condyle Fractures in Children

“…Fractures of the lateral humeral condylar physis, as the 2nd most common type of elbow fracture in children, constitute 16.9% of all distal humerus fractures (1,2). For acutely presented lateral condyle fracture (LCF) with more than 2 mm displacement, open reduction and internal fixation (ORIF) constitutes the gold standard treatment associated with good or excellent clinical and radiological outcomes (3)(4)(5). For LCF with lesser than 2 mm displacement, closed reduction and percutaneous fixation or immobilization are recommended as effective treatment options (3).…”