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Open reduction internal fixation of lateral humeral condyle fractures in children. A series of 105 fractures from a single institution
Lateral humeral condyle fractures account for 17 % of the distal humeral condyle fractures. Displaced and/or rotated fractures require appropriate reduction and stabilisation. There are, however, a number of controversies in the surgical management of these patients. The aim of the present study was...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Springer Milan
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4122681/ https://www.ncbi.nlm.nih.gov/pubmed/25022896 http://dx.doi.org/10.1007/s11751-014-0193-z |
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author | Leonidou, Andreas Chettiar, Krissen Graham, Simon Akhbari, Pouya Antonis, Konstantinos Tsiridis, Eleftherios Leonidou, Omiros |
author_facet | Leonidou, Andreas Chettiar, Krissen Graham, Simon Akhbari, Pouya Antonis, Konstantinos Tsiridis, Eleftherios Leonidou, Omiros |
author_sort | Leonidou, Andreas |
collection | PubMed |
description | Lateral humeral condyle fractures account for 17 % of the distal humeral condyle fractures. Displaced and/or rotated fractures require appropriate reduction and stabilisation. There are, however, a number of controversies in the surgical management of these patients. The aim of the present study was to review the results of patients with a displaced lateral humeral condyle fracture treated with open reduction and internal fixation (ORIF). We retrospectively reviewed children treated with ORIF of lateral humeral condyle fractures at a single institution over a period of 13 years. All cases were identified through the trauma register. Case notes and radiographs were retrieved. Fracture classification, mode of fixation, time to union, and final outcomes at the latest follow-up were reviewed. One hundred and five lateral condyle fractures were identified in 76 male and 29 female patients. Average age was 6.2 years. Ninety-two were Milch type II and 13 Milch type I. According to the Jacob’s classification, 38 were type II and 67 type III. All fractures were treated with open reduction and fixation with K-wires. Average time to radiological union was 33 days. Follow-up ranged between 2 and 8 years (average 3.2 years). Radiological hypertrophy of the lateral condyle was present in 45 cases (42 %). Three patients developed a pseudo-cubitus varus deformity. Further four patients developed a true cubitus varus. There was one case of superficial infection of the K-wires and one case of delayed union. At the latest follow-up, 96 % of the patients achieved an excellent final result and 4 % a good final result. Our results demonstrate that fracture union and excellent final outcomes can be expected in all patients using our protocol, whereby all patients with a displaced fracture are managed by ORIF with K-wire fixation, with the wires only being removed after there is evidence of radiological union. Compared to recent reports of closed reduction internal fixation, this series demonstrates good results with no complications directly relating to the open reduction technique. Level of evidence Case series, Level IV. |
format | Online Article Text |
id | pubmed-4122681 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Springer Milan |
record_format | MEDLINE/PubMed |
spelling | pubmed-41226812014-08-18 Open reduction internal fixation of lateral humeral condyle fractures in children. A series of 105 fractures from a single institution Leonidou, Andreas Chettiar, Krissen Graham, Simon Akhbari, Pouya Antonis, Konstantinos Tsiridis, Eleftherios Leonidou, Omiros Strategies Trauma Limb Reconstr Original Article Lateral humeral condyle fractures account for 17 % of the distal humeral condyle fractures. Displaced and/or rotated fractures require appropriate reduction and stabilisation. There are, however, a number of controversies in the surgical management of these patients. The aim of the present study was to review the results of patients with a displaced lateral humeral condyle fracture treated with open reduction and internal fixation (ORIF). We retrospectively reviewed children treated with ORIF of lateral humeral condyle fractures at a single institution over a period of 13 years. All cases were identified through the trauma register. Case notes and radiographs were retrieved. Fracture classification, mode of fixation, time to union, and final outcomes at the latest follow-up were reviewed. One hundred and five lateral condyle fractures were identified in 76 male and 29 female patients. Average age was 6.2 years. Ninety-two were Milch type II and 13 Milch type I. According to the Jacob’s classification, 38 were type II and 67 type III. All fractures were treated with open reduction and fixation with K-wires. Average time to radiological union was 33 days. Follow-up ranged between 2 and 8 years (average 3.2 years). Radiological hypertrophy of the lateral condyle was present in 45 cases (42 %). Three patients developed a pseudo-cubitus varus deformity. Further four patients developed a true cubitus varus. There was one case of superficial infection of the K-wires and one case of delayed union. At the latest follow-up, 96 % of the patients achieved an excellent final result and 4 % a good final result. Our results demonstrate that fracture union and excellent final outcomes can be expected in all patients using our protocol, whereby all patients with a displaced fracture are managed by ORIF with K-wire fixation, with the wires only being removed after there is evidence of radiological union. Compared to recent reports of closed reduction internal fixation, this series demonstrates good results with no complications directly relating to the open reduction technique. Level of evidence Case series, Level IV. Springer Milan 2014-07-15 2014-08 /pmc/articles/PMC4122681/ /pubmed/25022896 http://dx.doi.org/10.1007/s11751-014-0193-z Text en © The Author(s) 2014 https://creativecommons.org/licenses/by/4.0/ Open AccessThis article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited. |
spellingShingle | Original Article Leonidou, Andreas Chettiar, Krissen Graham, Simon Akhbari, Pouya Antonis, Konstantinos Tsiridis, Eleftherios Leonidou, Omiros Open reduction internal fixation of lateral humeral condyle fractures in children. A series of 105 fractures from a single institution |
title | Open reduction internal fixation of lateral humeral condyle fractures in children. A series of 105 fractures from a single institution |
title_full | Open reduction internal fixation of lateral humeral condyle fractures in children. A series of 105 fractures from a single institution |
title_fullStr | Open reduction internal fixation of lateral humeral condyle fractures in children. A series of 105 fractures from a single institution |
title_full_unstemmed | Open reduction internal fixation of lateral humeral condyle fractures in children. A series of 105 fractures from a single institution |
title_short | Open reduction internal fixation of lateral humeral condyle fractures in children. A series of 105 fractures from a single institution |
title_sort | open reduction internal fixation of lateral humeral condyle fractures in children. a series of 105 fractures from a single institution |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4122681/ https://www.ncbi.nlm.nih.gov/pubmed/25022896 http://dx.doi.org/10.1007/s11751-014-0193-z |
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