Closed Reduction and Percutaneous Pinning of Displaced Pediatric Lateral Condyle Fractures of the Humerus

Abstract

CRPP is a viable alternative for the treatment of pediatric LCFs with limited initial displacement (between 2 and 4 mm). In addition to the obvious cosmetic advantage of avoiding an unsightly scar, it is associated with decreased surgical times and does not significantly increase the incidence of complications.

Treatment of Pediatric Lateral Condylar Humerus Fractures with Closed Reduction and Percutaneous Pinning

“…Now this CRPP technique has been introduced in the latest edition of a classic book, Rockwood and Wilkins Fractures in Children [1]. A few later studies reported their results using this technique [15][16][17][18]. Silva et al claimed that CRPP is an alternative treatment of pediatric LCFs with displacement between 2 and 4 mm.…”

“…CRPP has shown several advantages over ORIF, including less dissection of soft tissue around the fragment, low risk of vessel damage, low risk of non-union and AVN of distal humerus physes, shorter operating room times, and avoidance of an open incision with unaesthetic scar [15,19], avoidance of another operation or anesthesia because of hardware removal. The present study demonstrated that closed reduction and percutaneous pinning is a novel and feasible technique for treating LCHFs with displacement more than 4 mm, and more than 3/4 of Song stage V or Jakob type III patients can avoid an incision.…”

“…Furthermore, several reports have recommended open reduction and internal xation (ORIF) as the best intervention for unstable fractures to prevent further displacement, nonunion, and malunion [4][5][6][7][8]. However, CRPP for treating pediatric lateral condylar humerus has been reported only in a few studies [9][10][11][12][13][14][15][16][17][18]. CRPP has shown several advantages over ORIF, including less dissection of soft tissue around the fragment, low risk of vessel damage, low risk of non-union and avascular necrosis (AVN) of distal humerus physeal, shorter operating room times, and avoidance of an open incision with an unaesthetic scar [15][16][17][18][19].…”

“…However, CRPP for treating pediatric lateral condylar humerus has been reported only in a few studies [9][10][11][12][13][14][15][16][17][18]. CRPP has shown several advantages over ORIF, including less dissection of soft tissue around the fragment, low risk of vessel damage, low risk of non-union and avascular necrosis (AVN) of distal humerus physeal, shorter operating room times, and avoidance of an open incision with an unaesthetic scar [15][16][17][18][19]. In most studies, this technique was used only in cases with displacement between 2-4 mm [9,12,15].…”

“…CRPP has shown several advantages over ORIF, including less dissection of soft tissue around the fragment, low risk of vessel damage, low risk of non-union and avascular necrosis (AVN) of distal humerus physeal, shorter operating room times, and avoidance of an open incision with an unaesthetic scar [15][16][17][18][19]. In most studies, this technique was used only in cases with displacement between 2-4 mm [9,12,15]. Song et al introduced a new classi cation and an internal oblique view to better assess the displacement of the fragment [20], and they managed to achieve closed reduction of the fracture, even in cases with displacement exceeding 4 mm or those with rotational displacement [13,14].…”