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Outcome of Lateral Condyle Fracture of Humerus in Children Stablized with K-Wires
Keywords:
Lateral condyle, k-wire fixation, open reduction, range of motionAbstract
Objective: To determine the radiological and functional outcome of open reduction and internal stabilization of lateral condyle humerus fracture in children.
Methods: This study was conducted in Orthopedic unit, Mardan medical complex, Mardan with a total number of 38 patients. The study duration was from from15 March 2017 to 14 March 2019.All the children had mean age of 6.68 (range; 2-14) years including 25 male and 13 female patients. Among them, 25 patients had Milch Type II while rest had Milch Type I fracture. All the patients were operated and stabilized with k-wire added by the back slab. Plaster removed after 6 weeks and k-wires within 4-6 week. All patients were followed on 2nd, 4th, 6th and at 12th week. At last, follow up the childrens were assessed for the union, carrying angle and elbow range of motion through Hardacre criteria.
Results: All fractures united in a mean time of 4.73 weeks with a range of 4-7weeks. Outcomes were excellent in 78.98% patients, good in 18.42 % and poor in 2.63%. No major complication reported in any case.
Conclusion: Open reduction and internal stablization with k-wire is an excellent method of fixing lateral condyle fractures in children with excellent radiological and functional results.
References
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2. Leonidou A, Chettiar K, Graham S, Akhbari P, Antonis K, Tsiridis E, et al. Open reduction internal fixation of lateral humeral condyle fractures in children. A series of 105 fractures from a single institution. Strategies in Trauma and Limb Reconstruction. 2014;9(2):73-8.
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8. Unal B, Ulusal AE, Vuruskaner H, Aydinoglu Y. Functional results of displaced lateral condyle fractures of the humerus with four-week K-wire fixation in children. Acta Orthop Traumatol Turc. 2005;39(3):193-8.
9. Andrey V, Tercier S, Vauclair F, Bregou-Bourgeois A, Lutz N, Zambelli P-Y. Lateral condyle fracture of the humerus in children treated with bioabsorbable materials. The Scientific World Journal. 2013;2013.
10. Pribaz JR, Bernthal NM, Wong TC, Silva M. Lateral spurring (overgrowth) after pediatric lateral condyle fractures. Journal of Pediatric Orthopaedics. 2012;32(5):456-60.
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12. Hardacre JA, Nahigian SH, FROIMSON AI, Brown JE. Fractures of the lateral condyle of the humerus in children. J Bon Joint surg 1971;53(6):1083-95.
13. Rizk AS, Essawy OM. Percutaneous fixation of pediatric humeral lateral condyle fractures. The Egyptian Orthopaedic Journal. 2017;52(4):263.
14. Thomas DP, Howard AW, Cole WG, Hedden DM. Three weeks of Kirschner wire fixation for displaced lateral condylar fractures of the humerus in children. Journal of Pediatric Orthopaedics. 2001;21(5):565-9.
15. Chan LWM, Siow HM. Exposed versus buried wires for fixation of lateral humeral condyle fractures in children: a comparison of safety and efficacy. Journal of children's orthopaedics. 2011;5(5):329-33.
16. Bratzler DW, Dellinger EP, Olsen KM, Perl TM, Auwaerter PG, Bolon MK, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Surgical infections. 2013;14(1):73-156.
17. Shaikh AM, Tunio MZ, Tebani KI Outcome of Displaced Lateral Condyle Humerus Fractures in Children Treated with K-wire Fixation. Journal of Pakistan Orthopaedic Association. 2015(3):113-6%V 27.
18. Mahmood K, Shah FA, Atiq G, Shahab-ud-din, Mehsud WM, Qureshi AR et al. Outcome of open reduction and internal fixation of fracture lateral condyle of humerus in children presented late. Pak J Surg. 2014;30(3):263-7.
19. Song KS, Shin YW, Oh CW, Bae KC, Cho CH. Closed reduction and internal fixation of completely displaced and rotated lateral condyle fractures of the humerus in children. Journal of orthopaedic trauma. 2010;24(7):434-7.
20. Gooi S, Chee E, Wong C, Mohana R, Khoo E, Thevarajan K. Retrospective review of Kirschner wire fixation and casting for displaced lateral condylar fracture of the humerus in children. Malaysian Orthopaedic Journal. 2008;2(2):17-20.
21. De SD, Bae DS, Waters PM. Displaced humeral lateral condyle fractures in children: should we bury the pins? Journal of Pediatric Orthopaedics. 2012;32(6):573-8.
22. McGonagle L, Elamin S, Wright D. Buried or unburied K-wires for lateral condyle elbow fractures. The Annals of The Royal College of Surgeons of England. 2012;94(7):513-6.
23. Li WC, Xu RJ. Comparison of Kirschner wires and AO cannulated screw internal fixation for displaced lateral humeral condyle fracture in children. International orthopaedics. 2012;36(6):1261-6.
24. Weiss JM, Graves S, Yang S, Mendelsohn E, Kay RM, Skaggs DL. A new classification system predictive of complications in surgically treated pediatric humeral lateral condyle fractures. Journal of Pediatric Orthopaedics. 2009;29(6):602-5.
25. Hung NN. Kirschner Wire Fixation of Neglected Lateral Condylar Fracture of the Humerus in Children. Open Access Library Journal. 2017;4(01):1.
2. Leonidou A, Chettiar K, Graham S, Akhbari P, Antonis K, Tsiridis E, et al. Open reduction internal fixation of lateral humeral condyle fractures in children. A series of 105 fractures from a single institution. Strategies in Trauma and Limb Reconstruction. 2014;9(2):73-8.
3. Sapkota HP, Rokaya PK, Rawal M, Karki DB, Limbu D. Early Versus Late Removal of Internally Fixated Kirschner’s Wires for Displaced Lateral Condyle Fracture of Humerus in Children. The open orthopaedics journal. 2018;12:229.
4. Hill CE, Cooke S. Suppl-8, M6: Common Paediatric Elbow Injuries. The open orthopaedics journal. 2017;11:1380.
5. Sawyer JR, Beaty JH. Lateral condylar and capitellar fractures of the distal humerus. Rockwood, Green, and Wilkins Fractures in Adults and Children: Eighth Edition: Wolters Kluwer Health Adis (ESP); 2014.
6. Song KS, Waters PM. Lateral condylar humerus fractures: which ones should we fix? Journal of Pediatric Orthopaedics. 2012;32:S5-S9.
7. Shabir A, Tahir A, Sharief A, Imtiyaz H, Shahid H, Reyaz A. Delayed operative management of fractures of the lateral condyle of the humerus in children. Malaysian orthopaedic journal. 2015;9(1):18.
8. Unal B, Ulusal AE, Vuruskaner H, Aydinoglu Y. Functional results of displaced lateral condyle fractures of the humerus with four-week K-wire fixation in children. Acta Orthop Traumatol Turc. 2005;39(3):193-8.
9. Andrey V, Tercier S, Vauclair F, Bregou-Bourgeois A, Lutz N, Zambelli P-Y. Lateral condyle fracture of the humerus in children treated with bioabsorbable materials. The Scientific World Journal. 2013;2013.
10. Pribaz JR, Bernthal NM, Wong TC, Silva M. Lateral spurring (overgrowth) after pediatric lateral condyle fractures. Journal of Pediatric Orthopaedics. 2012;32(5):456-60.
11. Conaway WK, Hennrikus WL, Ravanbakhsh S, Winthrop Z, Mahajan J. Surgical treatment of displaced pediatric lateral condyle fractures of the humerus by the posterior approach. Journal of Pediatric Orthopaedics B. 2018;27(2):128-33.
12. Hardacre JA, Nahigian SH, FROIMSON AI, Brown JE. Fractures of the lateral condyle of the humerus in children. J Bon Joint surg 1971;53(6):1083-95.
13. Rizk AS, Essawy OM. Percutaneous fixation of pediatric humeral lateral condyle fractures. The Egyptian Orthopaedic Journal. 2017;52(4):263.
14. Thomas DP, Howard AW, Cole WG, Hedden DM. Three weeks of Kirschner wire fixation for displaced lateral condylar fractures of the humerus in children. Journal of Pediatric Orthopaedics. 2001;21(5):565-9.
15. Chan LWM, Siow HM. Exposed versus buried wires for fixation of lateral humeral condyle fractures in children: a comparison of safety and efficacy. Journal of children's orthopaedics. 2011;5(5):329-33.
16. Bratzler DW, Dellinger EP, Olsen KM, Perl TM, Auwaerter PG, Bolon MK, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Surgical infections. 2013;14(1):73-156.
17. Shaikh AM, Tunio MZ, Tebani KI Outcome of Displaced Lateral Condyle Humerus Fractures in Children Treated with K-wire Fixation. Journal of Pakistan Orthopaedic Association. 2015(3):113-6%V 27.
18. Mahmood K, Shah FA, Atiq G, Shahab-ud-din, Mehsud WM, Qureshi AR et al. Outcome of open reduction and internal fixation of fracture lateral condyle of humerus in children presented late. Pak J Surg. 2014;30(3):263-7.
19. Song KS, Shin YW, Oh CW, Bae KC, Cho CH. Closed reduction and internal fixation of completely displaced and rotated lateral condyle fractures of the humerus in children. Journal of orthopaedic trauma. 2010;24(7):434-7.
20. Gooi S, Chee E, Wong C, Mohana R, Khoo E, Thevarajan K. Retrospective review of Kirschner wire fixation and casting for displaced lateral condylar fracture of the humerus in children. Malaysian Orthopaedic Journal. 2008;2(2):17-20.
21. De SD, Bae DS, Waters PM. Displaced humeral lateral condyle fractures in children: should we bury the pins? Journal of Pediatric Orthopaedics. 2012;32(6):573-8.
22. McGonagle L, Elamin S, Wright D. Buried or unburied K-wires for lateral condyle elbow fractures. The Annals of The Royal College of Surgeons of England. 2012;94(7):513-6.
23. Li WC, Xu RJ. Comparison of Kirschner wires and AO cannulated screw internal fixation for displaced lateral humeral condyle fracture in children. International orthopaedics. 2012;36(6):1261-6.
24. Weiss JM, Graves S, Yang S, Mendelsohn E, Kay RM, Skaggs DL. A new classification system predictive of complications in surgically treated pediatric humeral lateral condyle fractures. Journal of Pediatric Orthopaedics. 2009;29(6):602-5.
25. Hung NN. Kirschner Wire Fixation of Neglected Lateral Condylar Fracture of the Humerus in Children. Open Access Library Journal. 2017;4(01):1.
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Published
2019-09-02
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Section
Original Articles
How to Cite
Outcome of Lateral Condyle Fracture of Humerus in Children Stablized with K-Wires. (2019). Journal of Pakistan Orthopaedic Association, 31(02), 48-52. https://jpoa.org.pk/index.php/upload/article/view/310
