Comparison of closed and open reduction internal fixation of acutely displaced unstable lateral humeral condylar fractures in children: a prospective cohort study

Abstract

Background: Lateral humeral condylar fractures in children are considered the second most common type of fractures in pediatric elbows after supracondylar fracture. Conservative treatment of these types of fracture usually fails. Open reduction and internal fixation of these types of fractures has been the treatment of choice with regard to anatomical reduction and stable internal fixation. Complications of open reduction range from mild complications, such as scars of the skin incision, to severe, such as avascular necrosis of the lateral condyle. Closed reduction and percutaneous fixation of the fracture may give the same results as open reduction with regard to reduction and healing of the fracture but without the complications of open reduction. Methods: This prospective interventional study was conducted in 60 patients who had lateral humeral condylar fractures. Patients were grouped into two equal groups: one group was managed by closed reduction and internal fixation (CRIF), and the second group was managed by open reduction and internal fixation (ORIF). Results: The two groups were compared after the operation and 1-year follow-up. There was no difference between the two groups with regard to fracture healing and complications, with the exception of complications of wound healing and skin scarring after open reduction. Conclusions: Closed reduction and percutaneous pinning of lateral humeral condylar fractures gave the same results in bone healing without the complications of skin-incision healing that were found in open reduction. Level of Evidence: Level III.