Open versus closed reduction internal fixation for lateral condyle humeral fractures in children: a systematic review and meta-analysis

OBJECTIVE: The objective of this meta-analysis was to illustrate the clinical outcomes and safety of two different management options for Song stage 2–4 lateral condyle humeral fractures in children. METHOD: In January 2023, a systematic computer-based search was conducted. Data were retrieved for patients with two different management options for lateral condyle humeral fractures in children. The primary endpoints were clinical outcomes based on infection, avascular necrosis, and nonunion. After testing for publication bias and heterogeneity between studies, the data was aggregated for stochastic effect models when necessary. RESULTS: Eight clinical studies with 742 patients were eventually included in the meta-analysis. There was no significant difference between the closed reduction and percutaneous pinning, and open reduction and internal fixation in terms of the clinical outcomes based on infection, avascular necrosis, and nonunion (P > 0.05). CONCLUSIONS: Closed reduction and percutaneous pinning, as well as open reduction and internal fixation of lateral condyle humeral fractures in children, resulted in similar structural stability and functional outcomes. More high-quality randomized controlled trials are needed to determine this conclusion.