Condylar Fractures In Children Research Articles

Effect of Different Treatment Modalities for Condylar Fractures in Childhood on Mandibular Symmetry and Temporomandibular Joint Function: A Retrospective Study.

In a retrospective study of the effects of different treatment modalities of condylar fractures in childhood on mandibular symmetry and temporomandibular function, the cases selected for this article were adult patients who had sustained a condylar fracture in childhood. The aim was to investigate the effects of condylar fractures in children on the development and function of the mandible and their specific manifestations after the completion of mandibular development. According to the different treatment modalities, the patients were divided into the conservative treatment group and the open surgical treatment group, and the effects of the 2 treatment modalities on the patients' condylar healing, the difference in growth ability, and the symmetry of the jaws were evaluated. The effects of different treatment modalities of children's condylar fracture on the growth, development, and function of the mandible were investigated using the Ai and Di, the grading of the imaging results, and the 3-dimensional CT fixation measurements from the aspects of both clinical examination and imaging examination. The 2 groups had condylar malalignment and condylar morphology abnormality, and there was one case of joint ankylosis in the surgical treatment group. There was a statistical difference in the evaluation of condylar reconstruction between the 2 groups, and the condylar reconstruction in the surgical treatment group was better than that in the conservative treatment, and there was a statistical difference between the condylar length, condylar width, condylar height, and depth of TMJ fossa between the healthy side and the affected side in the closed treatment group. There was a statistical difference in the height of the mandibular ascending branch between the healthy side and the affected side, and the unilateral condylar fracture was treated conservatively; the difference in the bony chin point deviation between the 2 groups was not statistically significant. In children, after conservative treatment of condylar fracture, the growth of condylar process is poor, and the condylar shape and position are not as good as surgical repositioning, but through the proliferation of temporomandibular joint fossa, it can make up for the insufficient height of condylar process, which has no effect on the symmetry of the mandible, and the surgical treatment can achieve good anatomical repositioning, which has a greater effect on the symmetry of the mandible than the conservative treatment.

[Screw versus Kirschner wire fixation for lateral humeral condyle fractures in children:a meta analysis].

To compare screw versus Kirschner wire fixation in the treatment of lateral humeral condyle fractures in children. A systematic search was conducted in PubMed, Embase, the Cochrane library, Web of Science, China National Knowledge Internet(CNKI), Wanfang Datebase from in ception to February 2022. Studies comparing screws and Kirschner wire fixation in the treatment of lateral humeral condyle fractures in children were included. Outcome measures included and excluded by a set of inclusion and exclusion criteria and evaluated for their quality, their excellent and good rate of fracture healing, malunion, delayed union or nonunion, infection, limitation of elbow flexion or extension(>10°) were extracted and analyzed using software Rev Man 5.3. A total of 9 retrospective studies involving 647 patients were included, with 255 patients in the screw fixation group(including screw combined with Kirschner wire) and 392 patients in the Kirschner wire fixation group. Meta analysis showed the following:infection rate in the screw group was significantly lower than that in the Kirschner wire group[OR=0.22, 95%CI(0.09, 0.56), P=0.001]. There were no significant differences between the 2 groups in excellent and good rate of fracture healing, malunion rate(P>0.05). Subgroup analysis showed that infection rate in the screw-only group was significantly lower than that in the Kirschner wire group[OR=0.18, 95%CI(0.05, 0.65), P=0.009]. For lateral humeral condyle fractures, Screw fixation alone had a lower infection rate than kirschner wire fixation and screw combined with Kirschner wire fixation. There were no significant differences in the excellent and good rate of fracture healing, malunion. In terms of postoperative efficacy and safety of internal fixation, orthopaedic surgeons are more likely to recommend screws for fixation of lateral humeral condyle fractures in children.

Long-term outcome of nonunion of the lateral humeral condyle fracture in children: a multicentre retrospective study.

Lateral humeral condyle nonunion in children is a rare condition. The treatment protocol for nonunion of lateral humeral condyle remains controversial due to the potential complication. This study reports long-term functional outcomes of the nonunion of the lateral humeral condyle fracture. In addition, we identified the prognostic factors for nonunion of the lateral humeral condyle fracture. We conducted a multicentre retrospective cohort study of nonunion of lateral humeral condyle between January 1995 and December 2022. The patient's preoperative demographic information was reviewed. Potential risk factors of poor functional outcome, such as age, duration from initial injury, and fracture displacement, were retrieved. Functional outcomes at the latest follow-up visit were evaluated using the Mayo Elbow Performance Score (MEPS). Multivariable linear regression was deployed to evaluate the association of potential risk factors with the functional outcome. A total of 63 patients from eight medical centers were included, of which 60 were surgically treated. Patients' average age was 7.3years old, with a mean follow-up duration of sevenyears. All nonunion cases were successfully treated, resulting in a normalized humeroulnar angle. The rate of AVN was 16.7%. All patients reported excellent range of motion and MEPS at the latest follow-up. Multivariable linear regression demonstrated that Fracture displacement (β = -0.88, 95% CI -1.55 to -0.22, p = 0.010) and duration from initial injury (β = -0.09, 95% CI -0.17 to -0.02, p = 0.010) were statistically significant factors influencing functional outcome of lateral humeral condyle nonunion. Initial fracture displacement and duration from the initial injury are statistically significantly associated with elbow function in lateral humeral condyle nonunion. However, the effect size for these factors is relatively small and does not reach clinical significance. Despite this, the functional outcome is excellent in all patients, with an average follow-up duration of sevenyears.

Prospective review of open reduction and internal fixation with Kirschner wires (K-wires left exposed) fixation in displaced and rotated (Song V) lateral humerus condyle fractures in children

Background: Fractures of the lateral condyle of the humerus account for 10-15% of all elbow fractures in children. These include Salter Harris type 2 and type 4 growth plate injuries in which the fracture crosses the distal humeral growth plate and enter the elbow joint. Open reduction and internal fixation with K wire is treatment of choice for the displaced as well as minimally displaced lateral condyle fractures of children to prevent malunion, nonunion and further displacement. Methods: This was prospective analytical study conducted in Rajendra Institute of Medical Sciences, Ranchi from December 2020 to December 2022 which consisted of 30 patients (of whom only 27 were present for follow ups) who were treated by ORIF with K-wires fixation. We followed the classification pattern given by Song et al. Results were evaluated according to the criteria given by the Hardacre et al. Results: Major culprit for injuries was fall from height (44.4%), followed by playing indoor games (25.9%). RTA and sports each constituted of (14.8%). Functional outcomes based on Hardacre criteria are excellent (85.1%), good in 11.1% cases and fair in 3.7% cases. Conclusions: Our findings demonstrate that open reduction and internal fixation with 2 or 3 K-wires (which were left exposed) and immobilization with casting for 3-4 weeks is sufficient for most of displaced and rotated fractures of the lateral condyle of the humerus.

Supracondylar humeral fractures and lateral elbow condyle fractures in children: association between body weight, clinical signs, and fracture severity

Supracondylar humeral fractures and lateral elbow condyle fractures in children: association between body weight, clinical signs, and fracture severity

Finite element analysis of Kirschner wire fixation for lateral condyle fracture in children in the sagittal plane.

This study aims to find the optimal arrangement of the Kirschner wire (K-wire) in the sagittal plane for fixation of a pediatric lateral condylar humeral fracture (Milch type II) by using finite element analysis (FEA). A model of lateral condyle fracture in a 6-year-old boy was developed, and an XYZ coordinate system was established based on this model. The YZ plane was defined as the sagittal plane to investigate the impact of the angle formed by the first and second K-wires on stability. Two configurations were studied for each angle: parallel and divergent. Evaluation indicators included the maximum displacement of the fracture fragment and the maximum von Mises stress in the pins and bone. The model with a -60° angle showed the best performance in both evaluation indicators. The parallel and divergent pin configurations had different performances in each group. The displacement results for negative angles were similar, and this result was better than those for positive angles. We successfully created a model of pediatric lateral condyle humerus fracture (Milch type II) and performed K-wire fixation with varying sagittal plane configurations, combined with FEA. Our findings demonstrate that the angle of -60° between the two pins in the sagittal plane provided the highest level of stability, with divergent configurations proving superior to parallel pinning at this angle.

K Wires or Cannulated Screws for Fixation of Lateral Condyle Fractures in Children: A Systematic Review of Comparative Studies.

Lateral condyle fractures in children have been typically been treated operatively using Kirschner wires (K wire) or cannulated screws (CCS); however, a definitive choice of implant remains a matter of debate. This systematic review aims to determine if union and functional outcomes of these fractures are better with screw fixation. A search of PubMed, Medline, Cochrane, and Google scholar was performed in March 2021. The results were screened by title and abstract, and relevance and a quality assessment of the data were performed for the articles meeting the inclusion criteria. Articles comparing radiological and functional outcomes of lateral condyle fractures treated with K wires or screws were included for examination. Articles were excluded if they did not compare outcomes of K wires and CCS together, or were in a language other than English, technical notes, case reports, and articles, which describe the use of fixation methods other than K wire or CCS as well as biomechanical studies were also excluded. Risk of bias and quality assessment of included articles were also done. Seven clinical studies were included. 44.4% (n = 4) were retrospective review of records with level III evidence (77.7%, n = 7). Only two included articles had good-quality assessment scores. Union was reported in 85.7% % in K wire group and 99.6% in CCS group. Functional outcomes were not statistically significant between the two groups. Using screws to fix lateral condyle provides better union; however, there is no difference in the functional outcomes and complication rate between the two. Using screws or buried K wires adds the burden of an additional procedure for removal.

Transoral Endoscopic-Assisted Reduction and Internal Fixation of Mandibular Condylar Fractures in Children

Extraoral approaches for open reduction and fixation of condylar fractures in children are associated with serious risks of complications, including facial nerve injury, facial scarring, parotid fistula, and auriculotemporal nerve injury. The purpose of this study was to retrospectively evaluate the outcomes of transoral endoscopic-assisted open reduction and internal fixation of condylar fractures and hardware removal in pediatric patients. This study was designed as a retrospective case series. The study included pediatric patients admitted with condylar fractures that were indicated for treatment with open reduction and internal fixation. The patients were clinically and radiographically evaluated with regard to occlusion, mouth opening, lateral and protrusive movement of the mandible, pain, chewing and speech difficulties, and bone healing at the fracture site. CT images were used to assess the reduction of the fractured segment, the stability of fixation and progress of healing of the condylar fracture at follow-up visits. The same surgical treatment approach was applied to all patients. The data from the study were analyzed for a single group without any comparison to other groups. The technique was used for the treatment of 14 subcondylar fractures in 12 patients between the ages of 3 to 11years. A total of 28 transoral endoscopic-assisted approach to the condylar region either for reduction and internal fixation or hardware removal were applied. The mean operating time was 53.1 (±11.3) minutes for the fracture repair and 20 (±2.6) minutes for hardware removal, respectively. The mean follow-up time of the patients was 17.8 (±2.7) months (median: 18) months. All patients regained stable occlusion, satisfactory mandibular motion, stable fixation, and complete bone healing at the fracture site at the end of their follow-up period. There was no transient of permanent facial nerve or trigeminal nerve injury in any of the patients. Endoscopically assisted transoral approach is a reliable technique for reduction and internal fixation of condylar fracture and hardware removal in pediatric patients. The serious risks of extraoral approaches including facial nerve injury, facial scar, and parotid fistula can be eliminated by using this technique.

Functional Orthodontic Treatment of Mandibular Condyle Fractures in Children and Adolescent Patients: An MRI Follow-Up.

Background: The purpose of this study was to retrospectively evaluate and follow up a conservative treatment approach with functional orthodontic appliances for the management of mandibular condyle fractures in children and adolescent patients. Methods: Between 2020 and 2022, the treatment records of patients with mandibular condyle fractures receiving a functional orthodontic treatment (FOT) were evaluated. In addition to the clinical and functional findings, magnetic resonance images of the mandibular condyles and surrounding structures were assessed. Results: Out of 61 patients, 8 met the inclusion criteria. The follow-up examination records showed no functional limitations. In 75% of cases, mild midline deviations persisted (mean 1.1 mm) without significant alterations to the occlusal relationships. Magnetic resonance imaging (MRI) showed the remodeling of the condyles and the restitution of the ramus heights, even in dislocated and displaced fractures. In three cases, a partial displacement of the articular disc was observed at the follow-up. No differences in the remodeling patterns were noted depending on age, sex, or fracture location. Conclusions: A FOT led to favorable functional and morphologic outcomes, supporting the concept of a conservative functional approach in children and adolescent patients. Functional adjunctive therapy should be considered in the conservative treatment of mandibular condyle fractures in growing patients.

Serious Condylar Head Absorption in Children With Intracapsular Condylar Fractures Treated Operatively With Long Screws.

This study was performed to explore bone remodelling in children with intracapsular condylar fractures after the condylar fracture fragments were fixed using long screws and to offer possible explanations about the underlying mechanism. Records of children (less than 12y old) who sustained intracapsular condylar fractures and fixed with long screws from May 2012 to January 2015 were retrieved. Age, gender, dates of injury, admission, and discharge, mechanism of trauma, location and pattern of fracture, other mandibular fractures, treatment methods, and time of review were recorded and analyzed. Image dates of pretreatments and posttreatments, including the date of review, were also recorded. A total of 8 patients completed their follow-up, and all patients (n=5) who were followed up after more than 3 months showed serious resorption of the condylar head. The condylar head resorbed until the height (or articular surface) dropped and aligned with the surface of the screw. The shortest time of absorption, as shown by the computed tomography scan was 106 days, and the longest time was 171 days (average time of 141.8d). Intracapsular condyle fractures in children should be managed conservatively as much as possible. However, if the height of the fracture fragments drops remarkably, open reduction and rigid internal fixation become possible choices.

Closed reduction and percutaneous pinning versus open reduction and internal fixation for Jakob type 3 lateral condyle fractures in children.

The management of type 3 lateral condyle fractures (LCFs) remains controversial. The main goal of this study was to evaluate the feasibility of closed reduction and percutaneous pinning (CRPP) in patients with type 3 LCFs and to assess the outcome of such injuries according to the type of treatment, CRPP, or open reduction and internal fixation (ORIF). This is a retrospective review of prospectively enrolled children with type 3 LCF managed by CRPP or ORIF between 2018 and 2021. All patients were followed for at least 12months. Patients were divided into two groups according to the type of treatment, CRPP or ORIF. Demographic characteristics were recorded for all patients. Standard radiographs were used to identify, evaluate, and classify each fracture and to detect the presence of other concomitant bone lesions. The clinical outcome was assessed according to the Hardacre et al. criteria. Seventy-eight children with type 3 LCF were included; 42 were treated by CRPP (53.8%) and 36 by ORIF (46.2%); the mean follow-up time was 17.7months (range, 12.3-40.9). The baseline characteristics did not differ between the two groups of patients. Overall, successful CRPP could be achieved in 39 out of 42 patients (92.9%). The mean surgical time was 63.4 and 84.5min in patients treated by CRPP and ORIF, respectively (p = 0.01). Fluoroscopy time was significantly shorter in patients managed by ORIF than in those treated by CRPP (12 versus 40s, respectively; p < 0.001). Clinical outcome according to the Hardacre et al. criteria was excellent in 37 out of 39 (94.4%) and in 35 out of 36 patients (97.2%) treated by CRPP and ORIF, respectively (p = 0.09). CRPP management of paediatric type 3 LCF has clinical and radiographic outcomes similar to ORIF; if satisfactory reduction cannot be achieved by CRPP, conversion to ORIF should be considered.

Clinical value of MRI in evaluating and diagnosing of humeral lateral condyle fracture in children

BackgroundHumeral lateral condyle fractures (HLCFs) are common paediatric fractures. Radiographs are hard to accurately evaluate and diagnose the damage of articular epiphyseal cartilage in HLCFs.Methods60 children who should be suspected to be HLCFs in clinical practice from Dec 2015 to Nov 2017 were continuously included as the first part patients. Subsequently, 35 HLCFs patients with complete follow-up information who had no obvious displacement on radiograph were the second part patients. The sensitivity and specificity of radiograph and MRI in diagnosing of HLCFs and their stability were calculated respectively. Calculated the sensitivity and specificity of each scan sequence of MRI in diagnosing of HLCFs osteochondral fractures. The degree of fracture displacement was measured respectively. Compared the ratio of surgical treatment, secondary fracture displacement and complications between the stable fracture group and the unstable fracture group on MRI in part 2 patients.ResultsSensitivity of diagnosing HLCFs by MRI was significantly higher than radiograph (100.00% vs. 89.09%, P = 0.03). Sensitivity of diagnosing integrity of trochlear cartilage chain by MRI was 96.30%, which was significantly higher than that by radiograph (62.96%, P < 0.01). The sensitivity of cartilage sensitive sequence (3D-FS-FSPGR/3D-FSPGR) was different with FS-PDWI and FS-T2WI (P = 0.01 and P = 0.02, respectively). The degree of HLCFs displacement by MRI was higher than radiograph (P < 0.05). In the unstable fracture group, 5 cases (45.45%) had a fracture displacement of more than 2 mm on MRI, which was significantly higher than that in stable fracture group (0.00%, P < 0.01).ConclusionsMRI is superior to the radiograph of elbow joint in evaluating and diagnosing children HLCFs and their stability. The coronal 3D-FS-FSPGR/3D-FSPGR sequence is a significant sequence for diagnosing osteochondral fractures in HLCFs. MRI can provide important clinical value for treatment decisions of HLCFs without significant displacement.

Patient-reported outcomes after operative versus nonoperative treatment of pediatric lateral humeral condyle fractures.

Lateral humeral condyle fractures in children are treated with several approaches, yet it is unclear which has the best treatment outcomes. We hypothesized that functional outcomes would be equivalent between treatment types, reduction approaches, and fixation types. Our purpose was to assess patient-reported outcomes and complications by treatment type (operative versus nonoperative), reduction approach (open versus percutaneous), and fixation type (cannulated screws versus Kirschner wires).We retrospectively reviewed data from acute lateral humeral condyle fractures treated at our level-1 pediatric trauma center from 2008 to 2017. Patients were included if they were 8 years or older and had completed clinical follow-up. Fractures were categorized by fracture severity as mild (<2-mm displacement), moderate (isolated, 2- to 5-mm displacement), or severe (isolated, >5-mm displacement or >2-mm displacement with concomitant elbow dislocation or other elbow fracture). We extracted data on patient age, sex, treatment type, reduction approach, fixation type, patient-reported outcomes (shortened Disabilities of the Arm, Shoulder, and Hand and Patient Reported Outcome Measurement Information System upper extremity), treatment complications, and follow-up duration. Patients in the operative versus nonoperative group and across fracture severity subgroups did not differ significantly by age, sex, or follow-up duration. Bivariate analysis was performed to determine whether outcomes differed by intervention. Alpha = 0.05.No differences were observed in patient-reported outcomes between operative versus nonoperative groups for the mild and severe fracture subgroups. No differences were observed between approach (open versus percutaneous) or instrumentation (cannulated screw versus Kirschner wire fixation) for any outcome measure within the operative group. Patients whose fractures were stabilized with screws versus wires had significantly higher rates of return to the operating room (94% versus 8.3%, P < .001). The overall complication rate for our cohort was low, with no differences by treatment type or fracture severity.In our cohort, patient-reported outcomes were similar across fracture severity categories, irrespective of treatment or fixation type. Patients who underwent internal fixation with cannulated screws experienced significantly higher rates of return to the operating room compared with those treated with Kirschner wires but otherwise had similar complication rates and patient-reported outcomes.Level of Evidence: 3

Treatment of Unstable Occipital Condylar Fractures in Children—A STROBE-Compliant Investigation

Background and objectives: Occipital condyle fractures (OCF) occur rarely in children. The choice of treatment is based on the Anderson–Montesano and Tuli classification systems. We evaluated the outcome of unstable OCF in children and adolescents after halo-vest therapy. Materials and Methods: We treated 6 pediatric patients for OCF, including 3 patients (2 girls, 1 boy) with unstable OCF. Among the 3 patients with unstable OCF, 2 patients presented with an Anderson–Montesano type III and Tuli type IIB injury, while 1 patient had an Anderson–Montesano type I fracture (Tuli type IIB) accompanied by a C1 fracture. On admission, the children underwent computed tomography (CT) of the head and cervical spine as well as magnetic resonance imaging (MRI) of the cervical spine. We treated the children diagnosed with unstable OCF with halo-vest immobilization. Before removing the halo vest at the end of therapy, we applied the CT and MRI to confirm OCF consolidation. At follow-up, we rated functionality of the craniocervical junction (CCJ) based on the Neck Disability Index (NDI) and Questionnaire Short Form 36 Health Survey (SF-36). Results: All children achieved OCF consolidation after halo-vest therapy for a median of 13.0 weeks (range: 12.5–14.0 weeks). CT and MRI at the end of halo-vest therapy showed no signs of C0/C1 subluxation and confirmed the correct consolidation of OCF. The only complication associated with halo-vest therapy was a superficial infection caused by a halo-vest pin. At follow-up, all children exhibited favorable functionality of the CCJ as documented by the NDI score (median: 3 points; range: 3–11 points) and SF-36 score (median: 91 points; range: 64–96 points). Conclusions: In our small case series, halo-vest therapy resulted in good mid-term outcome in terms of OCF consolidation and CCJ functionality. In pediatric patients with suspected cervical spine injuries, we recommend CT and MRI of the CCJ to establish the diagnosis of OCF and confirm stable fracture consolidation before removing the halo vest.

Surgical treatment of a mandibular condyle fracture

The condylar region is the most frequent anatomical site for mandibular fractures in children. Most surgeons opt for functional treatment which is not satisfactory in the long term because of the appearance of facial asymmetry and TMJ dysfunction, hence the interest in surgical management of displaced condylar fractures. In this article, we will describe the case of a 7-year-old child who fell from a height and sustained a subcondylar fracture with anteromedial dislocation. The clinical examination revealed a disorder of the dental articulation with laterodeviation. A panoramic radiograph was done which confirmed the fracture and then we performed a CT scan with 3D reconstruction which informed us about the degree of displacement of the fracture. The treatment was surgical with a mini TCP plate which allowed the correction of all these clinical manifestations. We believe that surgical treatment of displaced mandibular condyle fractures in children is still essential to avoid long-term complications.

Complications of Lateral Humeral Condyle Fractures in Children

Lateral humeral condyle fractures in children are easily missed and often associated with complications. These complications include malunion, delayed union or nonunion, lateral spur formation, fishtail deformity and growth disturbances. There is also controversy related to best treatment options including closed vs open reduction and K-wire vs screw fixation. Though some complications like malunion are avoidable, others like lateral spur formation are inevitable. Knowledge about these complications would help in counseling patients and their families. The purpose of this article was to review common complications related to these fractures and suggest tips to avoid some of them. Keywords: Paediatric, Lateral condyle fracture, Internal oblique X-ray, Arthrogram, Anatomical reduction, Complications, Tips to overcome

Radiographic evaluation in three dimensions of condylar fractures with closed treatment in children and adolescents

The study aimed at investigating a new three-dimensional classification of healing morphology in condylar fractures in children and adolescents after closed treatment, and establish its association with fracture type and clinical outcomes.The medical records of children and adolescents with condylar fracture were reviewed, retrospectively. The clinical outcomes were assessed by mandibular deviation during mouth opening, Helkimo anamnestic index (Ai), and Helkimo clinical dysfunction index (Di). The condylar healing morphology was evaluated through three-dimensional CT images after 1–2 years of follow-up.In total, 96 patients with 142 condylar fracture sites were included in the study. Condylar healing morphology was classified into three main patterns: unchanged (21.13%), spherical (62.68%), and irregular (16.19% — including the three subtypes triangular, L-shaped, and Y-shaped). There was a significant difference in the distribution of the three main healing patterns among various fracture types (p = 0.0227). Irregular patterns occurred more frequently in adolescents than in children. In unilateral fractures, no obvious association was found between condylar healing morphology and clinical outcomes, including mandibular deviation during mouth opening (p = 0.162), Ai (p = 0.0991) and Di (p = 0.25). Most patients healing in different condylar patterns reached a good clinical outcome after 1–2 years.Although the healing morphology of condylar fractures in children and adolescents remained abnormal, good clinical outcome was achieved over the 2-year follow-up. Therefore, closed treatment remains a good approach.

Does an elbow arthrogram change management after closed reduction of mildly displaced lateral condyle fractures in children?

Does an elbow arthrogram change management after closed reduction of mildly displaced lateral condyle fractures in children?

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

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.

Comparison of radiological and clinical outcome among Kirschner wires versus 3.5 mm diameter cannulated cancellous screw internal fixation in treatment for the displaced lateral humeral condyle fractures in children

&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt; Lateral humeral condyle fracture, the second most common injury around the elbow, accounts for 10-20% of all fractures of the elbow in children with a high incidence between two and 14 years.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This hospital based prospective randomized comparative study design was include patients of both sexes in age group of 2 to 14 years attending SMS hospital, Jaipur during April 2018 to June 2019 or till the sample size achieved, with due permission from the institutional ethic committee and review board and after taking written informed consent from the patient.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results:&lt;/strong&gt; 40 patients out of 50 were grouped as excellent (70.1%) while 13 were found good (22.8%) and only four patients were found poor (7.01%) as per Hardacre criteria of assessment of lateral condyle treatment in k wire group while excellent, good and poor results were found 68.4, 24.5 and 7.01% respectively in CC screw groups&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; The displaced fractures (displacement over 2 mm) can be treated successfully by open reduction and K-wires or screw fixation with excellent results.&lt;/p&gt;&lt;p&gt; &lt;/p&gt;