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Comparison of Kirschner wires and AO cannulated screw internal fixation for displaced lateral humeral condyle fracture in children

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Abstract

Purpose

This retrospective study compares Kirschner wires versus 3.5-mm diameter AO cannulated screw internal fixation in treatment for the displaced lateral humeral condyle fractures.

Methods

The study included 62 patients (42 boys, 20 girls; mean age 6.93 years; age range two to 14 years) with displaced lateral humeral condyle fractures. All patients were treated by open reduction and Kirschner wires or cannulated screw fixation. The clinical outcomes were evaluated according to the criteria of Hardacre et al. The mean follow-up period was 39.4 months (range 21–95 months).

Results

There was no statistically significant difference in clinical outcome between these two groups (P > 0.05). Five patients (16.7%) developed skin infection around K-wires, while no infection occurred in fracture with screws. An obvious lateral prominence occurred in 11 (36.7%) patients with K-wires and four (12.5%) patients with screws. Nine (30%) patients with K-wires and two (6.3%) patients with screws had a lack of 10° of extension of the elbow compared with the other side.

Conclusion

Both K-wires and cannulated screw fixation are effective in treatment for displaced lateral humeral condyle fracture. K-wires can pass through the ossific nucleus of capitulum without damaging it, but a longer period of external fixation and local skin care will be required. The screws can reduce the possibility of lateral prominence and promote the function of elbow by continuously stabilising the fracture, but a second operation is need for screw removal.

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References

  1. Marzo JM, d'Amato C, Strong M, Gillespie R (1990) Usefulness and accuracy of arthrography in management of lateral humeral condyle fractures in children. J Pediatr Orthop 10(3):317–321

    Article  PubMed  CAS  Google Scholar 

  2. Jakob R, Fowles JV, Rang M, Kassab MT (1975) Observations concerning fractures of the lateral humeral condyle in children. J Bone Joint Surg Br 57(4):430–436

    PubMed  CAS  Google Scholar 

  3. Bast SC, Hoffer MM, Aval S (1998) Nonoperative treatment for minimally and nondisplaced lateral humeral condyle fractures in children. J Pediatr Orthop 18(4):448–450

    Article  PubMed  CAS  Google Scholar 

  4. Sharma H, Sibinski M, Sherlock DA (2009) Outcome of lateral humeral condylar mass fractures in children associated with elbow dislocation or olecranon fracture. Int Orthop 33(2):509–514. doi:10.1007/s00264-007-0463-1

    Article  PubMed  CAS  Google Scholar 

  5. Ersan O, Gonen E, Arik A, Dasar U, Ates Y (2009) Treatment of supracondylar fractures of the humerus in children through an anterior approach is a safe and effective method. Int Orthop 33(5):1371–1375. doi:10.1007/s00264-008-0668-y

    Article  PubMed  Google Scholar 

  6. Skak SV, Olsen SD, Smaabrekke A (2001) Deformity after fracture of the lateral humeral condyle in children. J Pediatr Orthop B 10(2):142–152

    Article  PubMed  CAS  Google Scholar 

  7. Toh S, Tsubo K, Nishikawa S, Inoue S, Nakamura R, Harata S (2002) Long-standing nonunion of fractures of the lateral humeral condyle. J Bone Joint Surg Am 84-A(4):593–598

    PubMed  Google Scholar 

  8. Hasler CC, von Laer L (2001) Prevention of growth disturbances after fractures of the lateral humeral condyle in children. J Pediatr Orthop B 10(2):123–130

    Article  PubMed  CAS  Google Scholar 

  9. Marcheix PS, Vacquerie V, Longis B, Peyrou P, Fourcade L, Moulies D (2011) Distal humerus lateral condyle fracture in children: when is the conservative treatment a valid option? Orthop Traumatol Surg Res 97(3):304–307. doi:10.1016/j.otsr.2010.10.007

    Google Scholar 

  10. Thomas DP, Howard AW, Cole WG, Hedden DM (2001) Three weeks of Kirschner wire fixation for displaced lateral condylar fractures of the humerus in children. J Pediatr Orthop 21(5):565–569

    Article  PubMed  CAS  Google Scholar 

  11. Cardona JI, Riddle E, Kumar SJ (2002) Displaced fractures of the lateral humeral condyle: criteria for implant removal. J Pediatr Orthop 22(2):194–197

    Article  PubMed  Google Scholar 

  12. Sharma JC, Arora A, Mathur NC, Gupta SP, Biyani A, Mathur R (1995) Lateral condylar fractures of the humerus in children: fixation with partially threaded 4.0-mm AO cancellous screws. J Trauma 39(6):1129–1133

    Article  PubMed  CAS  Google Scholar 

  13. Baharuddin M, Sharaf I (2001) Screw osteosynthesis in the treatment of fracture lateral humeral condyle in children. Med J Malaysia 56(Suppl D):45–47

    Google Scholar 

  14. Conner AN, Smith MG (1970) Displaced fractures of the lateral humeral condyle in children. J Bone Joint Surg Br 52(3):460–464

    PubMed  CAS  Google Scholar 

  15. Sulaiman AR, Munajat I, Mohd EF (2011) A modified surgical technique for neglected fracture of lateral humeral condyle in children. J Pediatr Orthop B 20 (6):366–371. doi:10.1097/BPB.0b013e32834920df

    Google Scholar 

  16. Chou PH, Feng CK, Chiu FY, Chen TH (2008) Isometric measurement of wrist-extensor power following surgical treatment of displaced lateral condylar fracture of the humerus in children. Int Orthop 32(5):679–684. doi:10.1007/s00264-007-0380-3

    Article  PubMed  Google Scholar 

  17. Saraf SK, Khare GN (2011) Late presentation of fractures of the lateral condyle of the humerus in children. Indian J Orthop 45 (1):39–44. doi:10.4103/0019-5413.67119

    Google Scholar 

  18. Milch H (1964) Fractures and fracture dislocations of the humeral condyles. J Trauma 4:592–607

    Article  PubMed  CAS  Google Scholar 

  19. Hardacre JA, Nahigian SH, Froimson AI, Brown JE (1971) Fractures of the lateral condyle of the humerus in children. J Bone Joint Surg Am 53(6):1083–1095

    PubMed  CAS  Google Scholar 

  20. Foster DE, Sullivan JA, Gross RH (1985) Lateral humeral condylar fractures in children. J Pediatr Orthop 5(1):16–22

    Article  PubMed  CAS  Google Scholar 

  21. Launay F, Leet AI, Jacopin S, Jouve JL, Bollini G, Sponseller PD (2004) Lateral humeral condyle fractures in children: a comparison of two approaches to treatment. J Pediatr Orthop 24(4):385–391

    Article  PubMed  Google Scholar 

  22. Ayubi N, Mayr JM, Sesia S, Kubiak R (2010) [Treatment of lateral humeral condyle fractures in children]. Oper Orthop Traumatol 22(1):81–91. (in German) doi:10.1007/s00064-010-3006-2

    Google Scholar 

  23. Weiss JM, Graves S, Yang S, Mendelsohn E, Kay RM, Skaggs DL (2009) A new classification system predictive of complications in surgically treated pediatric humeral lateral condyle fractures. J Pediatr Orthop 29(6):602–605. doi:10.1097/BPO.0b013e3181b2842c

    Article  PubMed  Google Scholar 

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The authors declare that they have no conflict of interest.

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Correspondence to Rui Jiang Xu.

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Li, W.C., Xu, R.J. Comparison of Kirschner wires and AO cannulated screw internal fixation for displaced lateral humeral condyle fracture in children. International Orthopaedics (SICOT) 36, 1261–1266 (2012). https://doi.org/10.1007/s00264-011-1452-y

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  • DOI: https://doi.org/10.1007/s00264-011-1452-y

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