Clinical and Radiographic Results of Lateral Condylar Fracture of Distal Humerus in Children

Koh, Kyoung Hwan; Seo, Sung Wook; Kim, Kyung Mu; Shim, Jong Sup

doi:10.1097/bpo.0b013e3181df1578

Cited by 50 publications

(53 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In these cases, the rate of deep infection is approximately 0.2% while that for superficial infection is 0.8% 6 . The infection rate of lateral condyle fractures has been noted to be higher (8.1%) but in the study by Koh et al it is not clear what proportion of K-wires were buried 7 . Some studies have directly compared buried and non-buried wires in lateral condyle fractures but no significant difference in outcome or complications was shown between the two groups 8 …”

Section: Discussionmentioning

confidence: 95%

Buried or unburied K-wires for lateral condyle elbow fractures

McGonagle

Elamin

Wright

2012

annals

View full text Add to dashboard Cite

INTRODUCTIONLateral humeral condyle fractures typically require a longer period of internal fixation than other distal humeral fractures due to the increased risk of non-union. K-wires can be buried and left in situ until union or they can be left unburied and require removal after four weeks, with plaster immobilisation until union. There is no consensus as to whether wire burial is preferable or not. The aim of this study was to determine whether K-wire burial is associated with more complications than non-buried wires in treating lateral condyle fractures of the elbow.METHODSAll patients with lateral humeral condyle fractures treated with K-wire fixation at our institution from May 2008 to August 2011 were included in the study. Fracture configuration, mode of reduction, wire burial and complications were assessed.RESULTSSixty-seven patients (19 girls and 48 boys, mean age: 6.5 years, range: 1–17 years) were included in the study. All had closed injuries and were treated with open reduction and K-wire fixation. K-wires were buried in 55 patients. Thirteen cases of buried wires eroded through skin and were removed on average 45 days (range: 30–58 days) post-operatively. Of the wire erosion cases, three developed microbiologically proven infections, one of which was a deep infection. There were a further three superficial wound infections in the absence of wire erosion through the skin. There were complications in 2 of the 12 cases in the unburied wires group: 1 microbiologically proven superficial wire site infection and 1 wire backed out after 11 days, requiring refixation.CONCLUSIONSWire erosion through the skin is the most common complication of K-wire burial. This may be due to the decrease in swelling after fracture fixation, making the wires more prominent under the skin. Skin integrity should be monitored closely if wires are buried.

show abstract

Section: Discussionmentioning

confidence: 95%

Buried or unburied K-wires for lateral condyle elbow fractures

McGonagle

Elamin

Wright

2012

annals

View full text Add to dashboard Cite

show abstract

“…Bony overgrowth (lateral spurring) over the lateral condyle is a distinct radiological finding commonly seen in children following a fracture of the lateral condyle of the humerus [12, 18]. A recent study by Pribaz et al [19] consisting of 212 lateral condyle fractures treated by various methods, demonstrated that 73 % of the patients developed some degree of lateral spur.…”

Section: Discussionmentioning

confidence: 99%

Open reduction internal fixation of lateral humeral condyle fractures in children. A series of 105 fractures from a single institution

Leonidou

Chettiar

Graham

et al. 2014

Strategies in Trauma and Limb Reconstruction

View full text Add to dashboard Cite

Lateral humeral condyle fractures account for 17 % of the distal humeral condyle fractures. Displaced and/or rotated fractures require appropriate reduction and stabilisation. There are, however, a number of controversies in the surgical management of these patients. The aim of the present study was to review the results of patients with a displaced lateral humeral condyle fracture treated with open reduction and internal fixation (ORIF). We retrospectively reviewed children treated with ORIF of lateral humeral condyle fractures at a single institution over a period of 13 years. All cases were identified through the trauma register. Case notes and radiographs were retrieved. Fracture classification, mode of fixation, time to union, and final outcomes at the latest follow-up were reviewed. One hundred and five lateral condyle fractures were identified in 76 male and 29 female patients. Average age was 6.2 years. Ninety-two were Milch type II and 13 Milch type I. According to the Jacob’s classification, 38 were type II and 67 type III. All fractures were treated with open reduction and fixation with K-wires. Average time to radiological union was 33 days. Follow-up ranged between 2 and 8 years (average 3.2 years). Radiological hypertrophy of the lateral condyle was present in 45 cases (42 %). Three patients developed a pseudo-cubitus varus deformity. Further four patients developed a true cubitus varus. There was one case of superficial infection of the K-wires and one case of delayed union. At the latest follow-up, 96 % of the patients achieved an excellent final result and 4 % a good final result. Our results demonstrate that fracture union and excellent final outcomes can be expected in all patients using our protocol, whereby all patients with a displaced fracture are managed by ORIF with K-wire fixation, with the wires only being removed after there is evidence of radiological union. Compared to recent reports of closed reduction internal fixation, this series demonstrates good results with no complications directly relating to the open reduction technique. Level of evidence Case series, Level IV.

show abstract

“…[11][12][13] Although closed reduction for displaced fractures remains controversial, recent studies have shown promising results. [12][13][14][15] Compression is important in these small, articular fractures, and the optimal mode of fixation for maintaining fracture reduction is debated. 14-17 Several constructs (eg, multiple smooth pins, single lag screw, and threaded pins) have been described.…”

mentioning

confidence: 99%