Functional outcome of displaced intercondylar fractures of the humerus in children and adolescents

Abstract

The main aim of this study was to retrospectively evaluate the clinical, functional, and radiographic outcome of displaced intercondylar fractures of the humerus in children and adolescents, and evaluate upper-extremity function with the short version of the Disabilities of the Arm, Shoulder and Hand outcome questionnaire (Quick DASH), the hypothesis being that intercondylar fractures have poorer functional outcome than do other upper-limb fractures. The mean age at the time of injury was 11.9±2.5 years (range: 7.5-15.8 years). The male-female ratio was 3.5 : 1. Using the Toniolo & Wilkins classification, 13 (72%) fractures were classified as type II and five (28%) as type III. The overall complication rate was 50%. The mean Quick DASH score was 9±11 (range: 0-31.8). Displaced intercondylar fractures of the humerus, although uncommon in skeletally immature patients, are characterized by poorer clinical and functional outcome compared with other pediatric humerus and elbow fractures. Minimally displaced fractures with articular surface displacement of less than 2 mm can be safely managed with closed reduction and percutaneous fixation, but any greater intra-articular displacement requires open reduction and internal fixation, which means a higher complication rate and poorer functional outcome should be expected, especially in patients older than 10 years.