A Modified Technique of Percutaneous Fixation of Displaced Pediatric Lateral Humeral Condyle Elbow Fractures (aka the Martini Technique): A Brief Case Series.

Abstract

Displaced lateral humeral condyle (LHC) fractures have routinely been treated with open reduction, which has known postoperative complications. Recent reports show that closed reduction and percutaneous pinning (CRPP) is a valid treatment. Five pediatric patients with displaced LHC fractures were included in a retrospective case series. Closed reductions (CRs) were facilitated by Kirschner wire placement into the capitellum through a toothed drill guide. The Kirschner wire and drill guide were used like a joystick to manipulate the fragment and maintain reduction for placement of additional Kirschner wires. Patient records were used to determine the number of patients diagnosed with LHC fractures between 2011 to 2022 among six pediatric orthopaedic surgeons at one institution along with the treatment and associated complications. Satisfactory reduction of displaced LHC fractures was achieved with CRPP in all patients with no complications using the "martini" modification. Of 26 LHC fractures, 16 were treated with CRPP/CRPS and 10 with open reduction and percutaneous pinning/open reduction and internal fixation, with four converted from CR to OR. Complications included one superficial infection in the CR group and four stiff elbows and one nonunion in the OR group option for LHC fractures. CRPP is an effective treatment option with a decreased risk of complications. Our modified reduction technique may help improve the success and results of closed treatment of LHC fractures.