Paediatric lateral condyle fracture with a posterolateral elbow dislocation: an atypical injury in a preadolescent

Wiekrykas, Bradley D; Campbell, Nancy; Greenhill, Dustin A.

doi:10.1136/bcr-2021-241725

Cited by 2 publications

(1 citation statement)

References 30 publications

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“…Sharma et al ( 26 ) suggested that the complex elbow anatomy, with characteristic appearances at different ages before skeletal immaturity, could contribute to a misdiagnosis. Wiekrykas et al ( 27 ) reported that a pediatric lateral condyle fracture with elbow dislocation was treated with ORIF using two 4.0 cannulated screws, and the elbow function of the patient recovered well. However, a secondary surgery was needed to remove the hardware.…”

Section: Discussionmentioning

confidence: 99%

Closed reduction and percutaneous pinning for treatment of unstable lateral condyle fractures of the humerus in children

Qiao,

Guan,

Jiang

et al. 2023

Front. Pediatr.

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ObjectiveIn the past, obviously displaced lateral condyle fractures of the humerus in children were treated satisfactorily with open reduction and internal fixation (ORIF). However, in recent years, more studies have mentioned closed reduction and percutaneous pinning (CRPP) of these fractures.MethodsIn this retrospective investigation, the radiographic and clinical results of patients with these fractures that were initially managed with CRPP were newly classified. We classified these fractures into three groups according to the degree and pattern of fracture displacement as identified on four radiographic images. In Type I, the fracture is unstable and displacement is ≥2 mm; In Type II degree I, the fracture is unstable and displacement is >2 mm, with single rotation of fragment; In Type II degree II, the fracture is unstable and displacement is >2 mm, with single rotation of fragment, with rotation of fragment and antero-proximal displacement; In Type III, the fracture is unstable and displacement is >2 mm, with posterior dislocation of elbow joint. We also designed an algorithm for closed reduction of these fractures according to this new classification.ResultsWe retrospectively analyzed the radiographic and clinical results of 37 unstable fractures (in 22 boys and 15 girls) that were treated with closed reduction. Twenty-one of 25 (84.0%) type I fractures, which could have been reduced to within 2 mm of residual displacement, were treated with closed reduction and pinning with 2 or 3 Kirschner wires (K wires). Three of 5 (60.0%) type II degree I, 3 of 4 (75.0%) type II degree II, and 3 of 3 (100%) type III fractures were treated with CRPP. In 4 of 25 (16.0%) type I, 2 of 5 (40.0%) type II degree I and 1 of 4 (25.0%) type II degree II fractures, closed reduction failed, so ORIF was implemented. There were no complications, such as nonunion, osteonecrosis of the capitellum, superficial or deep infection, malunion, cubitus varus or valgus, or early physeal arrest.ConclusionAlthough the management of type III fractures may not be more difficult than type II fractures with a rotated fracture fragment, as elbow dislocations are usually easy reducible. This retrospective study showed that type III fractures should not be ignored as a lateral condyle fracture that can be cured with CRPP and that lateral humeral condyle fractures with obvious displacement and rotation can be initially treated with CRPP to achieve satisfactory recovery of the elbow. Kirschner wire (K wire) fixation is recommended to avoid reoperation or anesthesia for hardware removal.

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Section: Discussionmentioning

confidence: 99%

Closed reduction and percutaneous pinning for treatment of unstable lateral condyle fractures of the humerus in children

Qiao,

Guan,

Jiang

et al. 2023

Front. Pediatr.

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Evlauation of Fixation Techniques in Naso-orbito-ethmoidal Fractures: A Comparative Study

Singh,

Taide,

Kaur

et al. 2024

Journal of Pharmacy and Bioallied Sciences

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Objective: Comparing fixation procedures for managing naso-orbito-ethmoidal (NOE) fractures. Methods: Group A (plate and screw fixation), Group B (Kirschner wire (K-wire) fixation), Group C (absorbable plate and screw fixation), and Group D (No fixation) were formed from 120 NOE fracture patients. The facial injury severity scale, visual analogue scale, CT scans, and clinical examination examined functional and cosmetic outcomes, complications, and postoperative stability. Results: The study found that plate and screw fixation (Group A) had the highest stability and aesthetic results, followed by absorbable plate and screw fixation (Group C). Conservative management (Group D) had the worst outcomes, while K-wire fixation (Group B) had good results but more complications. Results showed substantial differences in functional, aesthetic, complications, and postoperative stability between groups (P < 0.05). Conclusion: Plate and screw fixation is the most successful and dependable approach for treating NOE fractures, with superior functional and aesthetic outcomes, reduced complications, and higher postoperative stability than K-wire fixation, absorbable plate and screw fixation, and conservative care. Absorbable plate and screw fixation may function instead of metal. Conservative care should be rare. Larger multicenter randomized controlled trials should corroborate these findings.

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Paediatric lateral condyle fracture with a posterolateral elbow dislocation: an atypical injury in a preadolescent

Cited by 2 publications

References 30 publications

Closed reduction and percutaneous pinning for treatment of unstable lateral condyle fractures of the humerus in children

Closed reduction and percutaneous pinning for treatment of unstable lateral condyle fractures of the humerus in children

Evlauation of Fixation Techniques in Naso-orbito-ethmoidal Fractures: A Comparative Study

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