Abstract
Introduction:Lateral condyle fracture of the distal humerus is the second most common paediatric elbow fracture. Unstable, rotated and displaced (>2 mm) fractures are managed with open reduction and internal fixation with Kirschner’s wires or screws. Debate persists as for how long the Kirschner’s wires should be placed in situ after internal fixation. We aimed to compare the functional and radiological outcome after early versus late removal of internally fixated Kirschner’s wires for displaced lateral condyle fracture of distal humerus.Methods:Children that underwent early (3-4 weeks) or late (5-7 weeks) removal of Kirschner’s wire after open reduction and internal fixation for displaced lateral condyle fracture of humerus were observed for a period of minimum 6 months. Time to radiological union, carrying angle, range of motion was assessed and compared between early and late group. Functional outcome was compared using the Dhillon scoring system.Results:We report the outcome of 40 cases (20 cases in each early and late group). Radiological union was achieved in all the cases of both group at 12 weeks follow up. The mean loss of carrying angle was statistically insignificant (p = 0.394) between the early and late group. There was no significant difference between the early and late group in relation to arc of motion at 12 weeks (p=0.724) and 6 months (p=0.638) follow up. Using the Dhillon scoring system, there was 100% excellent Dhillon score in early group, 80% excellent and 20% good Dhillon score in late group. Functional outcome was statistically insignificant between the two groups (p = 0.106)Conclusion:Early removal of internally fixated K-wires for displaced lateral condyle fracture of humerus in children showed similar radiological and functional results to late removal.
Highlights
Lateral condyle fracture of the distal humerus is the second most common paediatric elbow fracture
Children that underwent early (3-4 weeks) or late (5-7 weeks) removal of Kirschner’s wire after open reduction and internal fixation for displaced lateral condyle fracture of humerus were observed for a period of minimum 6 months
No significant difference between early and late groups in relation to Range Of Motion (ROM) was seen at 12 weeks (p=0.724) and 6 months (p=0.638)
Summary
Lateral condyle fracture of the distal humerus is the second most common paediatric elbow fracture. Unstable, rotated and displaced (>2 mm) fractures are managed with open reduction and internal fixation with Kirschner’s wires or screws. We aimed to compare the functional and radiological outcome after early versus late removal of internally fixated Kirschner’s wires for displaced lateral condyle fracture of distal humerus. Lateral condyle fracture of the distal humerus is the second most common paediatric elbow fracture after supracondylar humeral fractures [1]. 230 The Open Orthopaedics Journal, 2018, Volume 12 population [2] They usually occur as the result of a fall onto outstretched hand with the elbow in full extension, forearm in supination with forced varus angulation. Functional loss of Range Of Motion (ROM) is common with displaced lateral condyle fracture of humerus because the fracture extends into the joint surface.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
