Traditionally, the initially nondisplaced pediatric humeral lateral condyle fractures
were treated conservatively, whereas displaced or rotated fractures were treated by
open reduction and internal fixation (ORIF). Late displacement and nonunion were
reported in some conservatively treated cases, whereas epiphyseal necrosis with
or without nonunion and elbow deformity were reported in some cases treated by
ORIF. Few studies have highlighted closed reduction and percutaneous fixation
(CRPF) of displaced and/or rotated fractures. The aim of this study is to assess the
outcome of CRPF for the treatment of pediatric humeral lateral condyle fractures.
Patients and methods
A prospective study included 45 cases of PHLCFs that were preoperatively
classified according to classification by Song and colleagues; all cases were
planned to have percutaneous fixation through either in-situ pinning if initially
nondisplaced or closed reduction if displaced or rotated. If closed reduction
failed, ORIF was done. The functional results were evaluated according to the
modified criteria of Aggarwal and colleagues.
Results
CRPF was successful in 80.48% of cases with displaced and/or rotated fractures,
with satisfactory clinical and radiological results and no reported surgery-related
complications in any case till the last follow-up, with a mean follow-up duration of
18.6±3.04 months. ORIF was done in only eight cases (representing 19.52% of the
studied cases) after failed closed reduction. There was a statistically significant
difference (P |
