Surgical Treatment of Late Presented Displaced Lateral Condylar Fracture of the Humerus in Children

Bae, Ki Cheor; Song, Kyung‐Bin; Kang, Chul Hyung; Min, Byung Woo; Cho, Chul-Hyun; Sakong, Hyub

doi:10.4055/jkoa.2008.43.1.24

Cited by 3 publications

(4 citation statements)

References 29 publications

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“…Compared to K C Bae [13] study the average age of the patients in our study was higher, and we observed satisfactory results of late open reduction even at higher mean age of patients and more delayed presentation of fractures compared to his study. The overall satisfactory results of patients in our study compared to K C Bae's study could be attributed to the modification of surgical technique, respecting the local biology of the fracture, and use of bone graft in fractures presenting more than six weeks after the injury.…”

Section: Mode Of Injurycontrasting

confidence: 58%

Late Open Reduction and Internal Fixation for Fractures of Lateral Condyle of Humerus in Children: A Clinical Study

Pant¹,

Huda²,

Julfiqar³

et al. 2013

jemds

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BACKGROUND: Neglected fracture of the lateral condyle of distal humerus in children is very common. Patients with non union of the lateral condylar fracture have pain, instability or a progressive cubitus valgus deformity, condylar prominence. A neglected displaced lateral humeral condyle fracture remains a difficult problem to treat. The bone ends become indistinct and soft tissue becomes contracted; making anatomic reduction difficult. Moreover an attempt to mobilize the fragment by stripping the soft tissues may lead to avascular necrosis. Several authors have recommended operative treatment for such patients, while others do not recommend operative intervention because stiff elbow and AVN are the usual outcomes. The present study was undertaken to assess the results of open reduction and internal fixation in neglected lateral humeral condyle fracture in children. MATERIAL AND METHODS: This is a prospective study carried out between November 2008 and July 2011 in the department of orthopedics at Teerthanker Mahaveer Medical College and research centre, Moradabad. Eighteen patients (14M:4F) with an average age of 7.3years (range 5.5 to 14 years) who had lateral humeral condyle fracture and reported 3 or more weeks after sustaining injury, were included in the study. The fractures were classified according to the Jacobs system. All patients were operated using the lateral approach and fixation was done using K wire or screw with or without bone grafting. The results were graded as excellent, good, fair or poor according to the modified criteria of Agarwal et al. RESULTS: There were 14 males and 4 females with a mean age of 7 years and 3 months (range 4-14 years). Among the nine (50%) patients who presented between 5 to 8 weeks after injury, the results were excellent in 3, good in 4, fair in 1 and poor in 1 patient. Excellent to good results were seen in all the five (27%) patients presenting between 3-5 weeks of injury. Among four (23%) patients out of total 18 patients who presented between 9-12 weeks of injury, 2 had poor results and 1 each had good and fair results. Maximum number of patients had Jacobs type 2 fractures. In our study 25% of these patients had showed excellent results, whereas only 12.5% of patients with type 3 fracture showed excellent results. Fourteen (n=14) patients underwent internal fixation with K wire and in four patients' fixation was done by cancellous screws. The commonest complication seen was pin tract infection (n=10), followed by occasional pain (n=5) around the elbow. There were no cases of avascular necrosis. CONCLUSION: Satisfactory functional results can be obtained even in late presenting fractures lateral condyles of the humerus in children with modification of surgical technique.

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Section: Mode Of Injurycontrasting

confidence: 58%

Late Open Reduction and Internal Fixation for Fractures of Lateral Condyle of Humerus in Children: A Clinical Study

Pant¹,

Huda²,

Julfiqar³

et al. 2013

jemds

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“…Delayed LCFH in children is not common, and only a few case series have been reported [ 4 , 5 , 12 , 13 ]. Besides, the optimal choice of treatment for this condition remains controversial [ 2 , 3 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…Besides, the optimal choice of treatment for this condition remains controversial [ 2 , 3 , 8 ]. The conservative method possibly results in poor clinical outcomes, including pain, instability of elbow joint, cubitus valgus deformity, and resultant ulnar nerve palsy [ 3 – 5 , 12 ]. However, surgical intervention carries a potential risk of AVN, infection, stiffness of the joint, and growth disturbance of distal humerus [ 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

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Biodegradable pins for lateral condylar fracture of the humerus with an early delayed presentation in children: a retrospective study of biodegradable pin vs. Kirschner wire

Rai

Gao

et al. 2020

BMC Musculoskelet Disord

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Background The clinical outcome of open reduction and internal fixation (ORIF) for delayed lateral condylar fracture of the humerus (LCFH) varies in different studies, but ORIF for LCFH with an early-delayed presentation usually resulted in significant improvement of elbow function. Early delayed presentation is defined as a period of 3 to 12 weeks from the injury. This study aims to compare the clinical outcomes of biodegradable pin (BP) vs. Kirschner wire (KW) in the treatment of LCFH with an early delayed presentation. Methods LCFH with an early-delayed presentation treated with KW or BP were retrospectively reviewed in our hospital. The patients were divided into two groups KW (n = 17) and BP group (n = 26). Baseline information, including sex, age, operative side, duration from injury to surgery, and implant choice, was reviewed. Radiographs and medical records were collected from the Hospital Database. Results In all, 17 patients (male/female, 9/8) in KW and 26 patients (male/female,13/13) in the BP group were included. The age showed no statistically significant difference between the KW (52.3 ± 10.2, month) and the BP (56.1 ± 10.7, month), (P = 0.258). At the last follow-up, there existed no statistically significant difference between the two groups concerning Baumann’s angle (P = 0.272) and carrying angle (P = 0.911). The MEPS at the last follow-up was better in the KW group (91.1 ± 2.7) than the BP group (89.2 ± 3.0), (P = 0.048). There was no case of nonunion or malunion in both groups. The incidence of fishtail deformity was (8/17, 47.1%) in KW and (13/26, 50%) in the BP group. The incidence of lateral prominence was (5/17, 29.4%) in the KW and (7/26, 26.9%) in the BP group. Furthermore, the incidence of implant prominence was higher in KW (12/17, 70.6%) than BP (0) (P < 0.001). Conclusion Open reduction and internal fixation for LCFH with an early-delayed presentation produced satisfactory outcomes. Biodegradable pin is a good alternative to Kirschner wire, with comparable clinical outcomes.

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Lateral Condyle Fractures

Mahmood

Dua

Abzug

2017

Pediatric Elbow Fractures

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Surgical Treatment of Late Presented Displaced Lateral Condylar Fracture of the Humerus in Children

Cited by 3 publications

References 29 publications

Late Open Reduction and Internal Fixation for Fractures of Lateral Condyle of Humerus in Children: A Clinical Study

Late Open Reduction and Internal Fixation for Fractures of Lateral Condyle of Humerus in Children: A Clinical Study

Biodegradable pins for lateral condylar fracture of the humerus with an early delayed presentation in children: a retrospective study of biodegradable pin vs. Kirschner wire

Lateral Condyle Fractures

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