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Radiologic, clinical, and functional evaluation of children with displaced T-condylar fractures treated by closed reduction and percutaneous fixation using the Mayo Elbow Performance Score

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Abstract

Purpose

T-condylar (T-C) fractures of the distal humerus are rare in children. There is no accepted treatment for such an injury, and there is a lack of reports evaluating the outcome of T-C fractures treated by closed reduction and percutaneous fixation. The aim of this study was to evaluate the feasibility of closed reduction and percutaneous K-wire and screw (CRPKS) fixation in patients with type II and III T-C fractures according to the Toniolo-Wilkins classification modified by Canavese et al. (TWC classification).

Methods

The clinical data of 12 consecutive patients (8 males, 4 females) who were younger than 14 years of age and who had a T-C fracture that was managed by CRPKS were retrospectively evaluated. Fractures were classified according to the TWC classification. The baseline information of the patients, carrying angle (CA) and Mayo Elbow Performance Score (MEPS) were used to evaluate clinical and functional outcomes; related complications were recorded. Statistical analysis was performed.

Results

The mean age at the time of injury was 11.6 ± 1.8 years (range, 8–14). The time from injury to surgical treatment was 1.5 ± 1.0 days (range, 0–3), and the mean follow-up duration was 33.7 ± 12.3 months (range, 18–61). Surgery lasted 45.7 ± 7.6 min on average (range, 35–58). All fractures healed in 4.9 ± 1.0 weeks on average (range, 4–7). At the last follow-up visit, the CA was 12.6° ± 5.8° on the injured side and 13.8° ± 1.8° on the uninjured side (p=0.432). The MEPS was 100 (95, 100) on the injured side and 100 (100, 100) on the uninjured side (p=0.194). Three complications were recorded.

Conclusion

Good functional and radiological outcomes can be expected in pediatric patients with type II and III T-C fractures treated by CRPKS. The technique is relatively simple to perform and has a lower rate of complications.

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Funding

The authors gratefully acknowledge the financial support of Fujian Provincial Clinical Medical Research Center for First Aid and Rehabilitation in Orthopaedic Trauma (2020Y2014) and the Key Clinical Specialty of Fujian Province and Fuzhou City (20220104).

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Authors and Affiliations

  1. Department of Paediatric Orthopaedics, Fuzhou Second Hospital, The Third Clinical Medicine College of Fujian Medical University, 47th Shangteng Road of Cangshan District, Fuzhou, 350007, Fujian Province, China

    Yunan Lu, Ran Lin, Yuchen Pan, Nuoqi Pan, Jinglin Lai & Shunyou Chen

  2. Department of Paediatric Orthopaedic Surgery, Jeanne de Flandre Hospital, Lille University Centre, Rue Eugène Avinée, 59000, Lille, France

    Federico Canavese

  3. Fujian Provincial Clinical Medical Research Center for First Aid and Rehabilitation in Orthopaedic Trauma (2020Y2014), Fuzhou, 350007, China

    Shunyou Chen

  4. Key Clinical Specialty of Fujian Province and Fuzhou City (20220104), Fuzhou, China

    Shunyou Chen

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  1. Yunan Lu
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  2. Federico Canavese
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  3. Ran Lin
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  4. Yuchen Pan
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Contributions

Yunan Lu: design of the study, manuscript preparation, statistical analysis, revision. Ran Lin and Jinglin Lai drafted the manuscript.

Yuchen Pan and Nuoqi Pan: statistical analysis and revision of the manuscript.

Federico Canavese: design of the study, manuscript preparation, statistical analysis, revision.

Shunyou Chen: design of the study, surgery and general supervision of the research group.

All authors read and approved the final manuscript.

Corresponding author

Correspondence to Shunyou Chen.

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Ethics approval

All procedures in studies involving human participants were performed in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This was a retrospective study, and IRB approval was obtained (approval No. 2023109).

Conflict of interest

Yunan Lu, Federico Canavese, Ran Lin, Yuchen Pan, Nuoqi Pan, Jinglin Lai and Shunyou Chen declare that they have no competing interests.

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Lu, Y., Canavese, F., Lin, R. et al. Radiologic, clinical, and functional evaluation of children with displaced T-condylar fractures treated by closed reduction and percutaneous fixation using the Mayo Elbow Performance Score. International Orthopaedics (SICOT) 48, 1471–1479 (2024). https://doi.org/10.1007/s00264-023-06058-4

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