Lateral Humeral Condyle Research Articles

Long-term results of closed-wedge osteotomy of the lateral humeral condyle for osteochondritis dissecans of the capitellum

Various surgical methods are used for osteochondritis dissecans of the capitellum; however, we have consistently performed a closed-wedge osteotomy of the lateral humeral condyle since 1983. The purpose of this study is to clarify the long-term results of closed-wedge osteotomy for osteochondritis dissecans of the capitellum. Seventy-seven elbows with all lesion types of osteochondritis dissecans of the capitellum were treated with closed-wedge osteotomy. Unstable osteochondral fragments were fixed with a bone graft and bone pegs in combination with osteotomy. The mean age of the patients was 14.0 years. The patients were clinically and radiographically evaluated at a median value of 9.0 years after surgery. The range of elbow motion and standard deviation were increased significantly from 119° ± 22° preoperatively to 131° ± 18° postoperatively (P < .001). The Timmerman and Andrews score were improved significantly from 141 ± 26 points preoperatively to 184 ± 21 points postoperatively (P < .001). The Timmerman and Andrews score and the range of elbow motion at final examination in patients with preoperative osteoarthritic changes were significantly inferior to those in patients without preoperative osteoarthritic changes. Good remodeling of the capitellar lesions was radiographically observed in 53 elbows (69%). In the long-term follow-up evaluation, although 41 elbows (53%) had advanced osteoarthritic changes that were classified as grade II or III, disease progression was controlled in most of these cases. Good or excellent long-term clinical results were maintained in most of our patients. Closed-wedge osteotomy of the lateral humeral condyle is a useful method that can provide acceptable long-term clinical results.

Retrospective Evaluation of The Result of Fixation of Lateral Humeral Condyle Fractures by K-Wires versus Cannulated Screws in Children

Retrospective Evaluation of The Result of Fixation of Lateral Humeral Condyle Fractures by K-Wires versus Cannulated Screws in Children

Retrospective Evaluation of The Result of Fixation of Lateral Humeral Condyle Fractures by K-Wires versus Cannulated Screws in Children

Background: fractures of the lateral condyle of the humerus represent the second most common type of fracture of the elbow in children. Although this injury is seen at all ages, it is predominately observed in children aged between 5 and 10 years. Objective: the purpose of this study is retrospective evaluation of the results of fixation of lateral humeral condyle by K-wires versus cannulated screws in children by assessment of: 1-Time to full union. 2-Range of motion.3- Percentage of complications. 4-According to Hardacre criteria. Patients and methods: a retrospective study for evaluation of the result of fixation of lateral humeral condyle fractures in children by K-wires vs cannulated screws. Our series was conducted in Al-Azher University Hospitals. 20 patients with humeral condyle fractures were treated by K-wires and cannulated screws. Results: in group A patients presented by complications as following: extension lag 1 (10%), delayed union (healing at 3–6 months) 1 (10%), revision 1 (loss of reduction at the 3rd day of operation and required revision using pin fixation) (10%), fish tail deformity 0 (0%) and 7 (70%) had no complications. While in group B: extension lag 1 (10%), delayed union 2 (20%), nonunion 1 (10%) (Not healed at greater than 6 months and reoperated using bone graft and pin fixation), revision 0 (0%), fish tail deformity 1 (10%), pin tract infection 1 (10%) and 4 (40%) had no complications. Conclusion: our study supports that screw fixation may be a viable option, with no nonunions and fewer complications than pin fixation.

Frequency of Secondary Dislocations of Initially non Displaced and Minimally Displaced Fractures of the Lateral Humeral Condyle in Children - Surveillance of a Treatment Algorithm.

The treatment of undisplaced fractures of the lateral humeral condyle is conservative. However, it is problematic that it is not possible to differentiate between a stable and an unstable, non-displaced fracture. A pragmatic approach is to X-ray the elbow without a cast 5 days after trauma and to compare those images with the initial ones. If there is a central increase of dislocation, then there is an indication of an unstable fracture. The dislocation can also be indicated by a translational movement, which is best observed in the border area. The aim of the study was to retrospectively determine the incidence of secondary dislocations of initially undisplaced and minimally dislocated fractures of the lateral humeral condyle in infants between 2010 and 2015. We performed a retrospective, non-randomized analysis of 75 children with initially undisplaced and minimally displaced fractures of the lateral humeral condyle between 2010 and 2015. The strategy for the evaluation of a stable and an unstable fracture of the lateral humeral condyle was carried out by means of an X-ray without a cast 5 days after trauma. Further radiological controls were performed after 14 days, 4 weeks and after 10 to 12 weeks in operated children. Seven initially undisplaced and minimally dislocated fractures (9,3%) showed a secondary dislocation 5 days after trauma when a radiological control without a cast was performed. At the control 14 days after trauma there was no further secondary dislocation. The immobilization took place in an upper arm cast for a period of 4 weeks. 90% of all non-dislocated fractures of the lateral humeral condyle can be treated conservatively. It is important to find out which about 10% of children will experience a secondary dislocation safely and effectively. It has been shown that the strategy for the evaluation of a stable and an unstable fracture of the lateral humeral condyle by means of a radiological control after 5 days without a cast can be effective and cost-saving. With a high degree of certainty, the unstable fracture can be detected at the radiological control 5 days after trauma. If, after 5 days, the radiological control reveals unsure finding regarding the dislocation, it is advisable to recheck the fracture in the second radiological control after 14 days.

Minimally Displaced Humeral Lateral Condyle Fractures: Immobilize or Operate When Stability Is Unclear?

Either casting or in situ fixation (to prevent displacement) are recommended for minimally displaced pediatric lateral condyle fractures of indeterminate stability with ≤2 mm lateral displacement and narrowed fracture extension to the epiphyseal articular cartilage. This study compares casting only, acute prophylactic in situ pinning, and surgery if casting fails due to displacement. In total, 738 fractures at a level 1 trauma center between 2008 and 2014 were reviewed. All fractures were assigned a Song classification and Song 2 fractures followed to union were analyzed. Worsening displacement was defined as an increase in Song stage. Patients were grouped per treatment: (1) cast only; (2) in situ pinning; or (3) closed or open reduction percutaneous pinning after displacement during attempted cast treatment. In total, 139 fractures were included and 45 (32%) underwent surgery. Among 114 fractures intended for casting, only 20 (18%) displaced and needed surgery. This implies 82% of fractures prophylactically pinned in situ may have remained stable in a cast. On average, displaced fractures were noted 6.5 (2 to 13) days after presentation and required 1 extra clinic visit and week of immobilization without increased complications. Surgeons chose open reduction percutaneous pinning more often for displaced fractures. Our data estimate 82% of Song 2 fractures never meaningfully displace in a cast. Meaningful displacements occur in <2 weeks. Benefits of prophylactic pinning include 1 less x-ray and clinic visit in exchange for a clinically insignificant lateral cortex reduction and inherent surgical risks. Compliance, surgical scheduling, and a higher rate of open reduction after displacement should influence early treatment decisions. Level III.

Diagnostic échographique des fractures peu déplacées du condyle huméral chez l’enfant : une nouvelle technique

IntroductionManagement of minimally displaced lateral humeral condyle fractures in pediatric patients is controversial. This is primarily because with current imaging modalities it is difficult to accurately and conveniently determine the stability of the fractures by detecting the integrity of the cartilage hinge. Nevertheless, transverse ultrasonography has not been intensively reported in previous studies. HypothesisTransverse ultrasonography can determine the integrity of the cartilage hinge in minimally displaced lateral condyle fractures. Materials and methodsWe retrospectively reviewed the medical records of 39 pediatric patients with minimally displaced fractures of the lateral humeral condyle who underwent transverse ultrasonography between 2014 and 2017. Conservative treatment was given to pediatric patients with intact cartilage hinges that had been confirmed by transverse ultrasound images. Surgical treatment was recommended for pediatric patients with disrupted cartilage hinges. Data regarding healing of the lateral humeral condyle fractures were recorded and analyzed. ResultsAccording to transverse ultrasonography, there were 14 children with intact cartilage hinges and 25 children with disrupted cartilage hinges. Fourteen children with intact cartilage hinges of the fracture were treated conservatively, and none of them showed secondary displacement. There were 16 children in whom there was surgical intervention, and 9 other children decided to have conservative treatment among the 25 children with disruption of the cartilage hinge. Five of these 9 children who underwent conservative treatment were found to have further displacement during an average of 12.6 days after the fracture event, and no other patient was found to have further displacement. ConclusionTransverse ultrasonography can simply and accurately determine the stability of minimally displaced lateral condyle fractures without sedation, ionizing radiation or invasive techniques. We recommend routine use of transverse ultrasonography to detect stability of the fractures, which can effectively avoid inadequate treatment and unnecessary surgery in pediatric patients with minimally displaced fractures of the lateral humeral condyle. Level of evidenceIV, retrospective cohort study.

A novel transverse ultrasonography technique for minimally displaced lateral humeral condyle fractures in children

IntroductionManagement of minimally displaced lateral humeral condyle fractures in pediatric patients is controversial. This is primarily because with current imaging modalities it is difficult to accurately and conveniently determine the stability of the fractures by detecting the integrity of the cartilage hinge. Nevertheless, transverse ultrasonography has not been intensively reported in previous studies. HypothesisTransverse ultrasonography can determine the integrity of the cartilage hinge in minimally displaced lateral condyle fractures. Materials and methodsWe retrospectively reviewed the medical records of 39 pediatric patients with minimally displaced fractures of the lateral humeral condyle who underwent transverse ultrasonography between 2014 and 2017. Conservative treatment was given to pediatric patients with intact cartilage hinges that had been confirmed by transverse ultrasound images. Surgical treatment was recommended for pediatric patients with disrupted cartilage hinges. Data regarding healing of the lateral humeral condyle fractures were recorded and analyzed. ResultsAccording to transverse ultrasonography, there were 14 children with intact cartilage hinges and 25 children with disrupted cartilage hinges. Fourteen children with intact cartilage hinges of the fracture were treated conservatively, and none of them showed secondary displacement. There were 16 children in whom there was surgical intervention, and 9 other children decided to have conservative treatment among the 25 children with disruption of the cartilage hinge. Five of these 9 children who underwent conservative treatment were found to have further displacement during an average of 12.6 days after the fracture event, and no other patient was found to have further displacement. ConclusionTransverse ultrasonography can simply and accurately determine the stability of minimally displaced lateral condyle fractures without sedation, ionizing radiation or invasive techniques. We recommend routine use of transverse ultrasonography to detect stability of the fractures, which can effectively avoid inadequate treatment and unnecessary surgery in pediatric patients with minimally displaced fractures of the lateral humeral condyle. Level of evidenceIV, retrospective cohort study.

Treatment principles and outcome after fractures of the lateral humeral condyle in children

Fractures of the lateral humeral condyle with displacement (>2 mm; <2 mm articular gap) require open reduction and stabilization. Non-displaced fractures should be treated conservatively; however, there are difficulties in the differentiation of complete (potentially unstable) an incomplete (stable) articular fractures. The aim of this study was to analyze the frequency of conservative and operative treatment approaches as well as the accuracy of treatment decisions based on fracture stability displayed on repetitive X‑rays. A retrospective data analysis of all lateral humeral condyles in children <16 years old treated between 2005 and 2014 was carried out. The patients were classified according to the fracture stability at the time of the incident (primarily stable or unstable) and after 4 days (secondarily stable or unstable) using conventional X‑ray images. Atotal of 89fractures of the lateral humeral condyle were treated (mean age 6.4years, range 0.9-14 years). Of the fractures 52 (58%) were initially not displaced and 37 (42%) were initially displaced. The latter underwent open reduction and stabilization by osteosynthesis (primarily stable). Of the 52 initially not displaced fractures 35 remained stable and conservative treatment in a plaster cast was performed (primarily and secondarily stable). In 8 out of 52cases asecondary displacement (>2 mm articular gap) occurred after an average of 6 days (range 3-10 days) and operative treatment was initiated (primarily stable and secondarily unstable). No follow-up x‑ray could be performed in 2 of the 52fractures and at the end of treatment the fractures healed with displacement (primarily stable and secondarily unstable). In 7 of the 52fractures operative treatment was performed although no displacement (primarily stable) was initially documented (overtreatment). The outcome of the whole study cohort was comparable with that described in the literature. Treatment decisions in pediatric lateral humeral condyle fractures are based on the primary and secondary fracture stability as observed in staged follow-up radiographs. Stable fractures, whether complete or incomplete, healed with good results after conservative treatment and overtreatment could be avoided. Unstable fractures, whether primary or secondary during the course, need to be recognized as such and operative treatment with astable osteosynthesis must be initiated.

A case report of total elbow arthroplasty for elbow osteoarthritis, in association with nonunion of the lateral humeral condyle, after distal humeral fractures in the childhood

A case report of total elbow arthroplasty for elbow osteoarthritis, in association with nonunion of the lateral humeral condyle, after distal humeral fractures in the childhood

Closed reduction and percutaneous pinning for the treatment of lateral humeral condyle fracture

Objective The aim of the present study was to evaluate the result of treatment of recent fracture of the lateral humeral condyle in children using closed reduction and percutaneous pinning. Background Few reports have focused on closed reduction and internal fixation of fractures of the lateral humeral condyle in children. We prospectively studied closed reduction and internal fixation to determine its usefulness as the treatment for fractures of the lateral condyle of the humerus in children. Patients and methods The lateral condylar humeral fractures were classified into three groups according to the degree of displacement and the fracture pattern as determined on four radiographic views (Jacob classification). On the basis of this classification system, we prospectively treated 60 fractures and assessed the quality of closed reduction according to the criteria of Hardacre and colleagues Results All six patients of stage 1 fractures were reduced to 1 mm of residual displacement with excellent results. A total of 42, stage 2 fractures were reduced to less than 2 mm of displacement with excellent results and four patients had good results. In six patients of stage 3 had excellent results and two patients had good result. There were no major complications such as early physeal arrest, osteonecrosis of the trochlea or capitellum, nonunion, malunion or osteomyelitis. Conclusion Closed reduction and internal fixation is an effective treatment for lateral humeral condylar fractures of the humerus in children. If fracture displacement, after closed reduction exceeds 2 mm, open reduction and internal fixation is recommended.

Severe cubitus varus deformity after repeated fracture of the lateral humeral condyle following distal humeral epiphyseal separation : a case report

Severe cubitus varus deformity after repeated fracture of the lateral humeral condyle following distal humeral epiphyseal separation : a case report

In vivo 3-dimensional Kinematics of Cubitus Valgus after Non-united Lateral Humeral Condyle Fracture.

BackgroundNonunion of lateral humeral condyle fracture causes cubitus valgus deformity. Although corrective osteotomy or osteosynthesis can be considered, there are controversies regarding its treatment. To evaluate elbow joint biomechanics in non-united lateral humeral condyle fractures, we analyzed the motion of elbow joint and pseudo-joint via in vivo three-dimensional (3D) kinematics, using 3D images obtained by computed tomography (CT) scan.MethodsEight non-united lateral humeral condyle fractures with cubitus valgus and 8 normal elbows were evaluated in this study. CT scan was performed at 3 different elbow positions (full flexion, 90° flexion and full extension). With bone surface model, 3D elbow motion was reconstructed. We calculated the axis of rotation in both the normal and non-united joints, as well as the rotational movement of the ulno-humeral joint and pseudo-joint of non-united lateral condyle in 3D space from full extension to full flexion.ResultsUlno-humeral joint moved to the varus on the coronal plane during flexion, 25.45° in the non-united cubitus valgus group and -2.03° in normal group, with statistically significant difference. Moreover, it moved to rotate externally on the axial plane -26.75° in the non-united cubitus valgus group and -3.09° in the normal group, with statistical significance. Movement of the pseudo-joint of fragment of lateral condyle showed irregular pattern.ConclusionsThe non-united cubitus valgus group moved to the varus with external rotation during elbow flexion. The pseudo-joint showed a diverse and irregular motion. In vivo 3D motion analysis for the non-united cubitus valgus could be helpful to evaluate its kinematics.

Fixation of Lateral Humeral Condyle by Screw in Children

Background: fractures of the lateral condyle of the humerus represent the second most common type of fracture of the elbow in children. Although this injury is seen at all ages, it is predominately observed in children aged between 5 and 10 years. These injuries are typically the result of an avulsion of a portion of the humeral condyle by pull of the extensor musculature due to a varus force on a supinated forearm or by the direct force of the radial head onto the condyle in the setting of a fall and axial load through an extended elbow. Objective: the purpose of this study was to evaluate the results of fixation of lateral humeral condyle by screw in children by assessment of time to full union, range of motion, and percentage of complications according to Hardacre criteria. Patients and Methods: a randomized prospective interventional study aiming at evaluating of open reduction and fixation of lateral humeral condyle by screw. Our series was conducted in Wadi El- Natroun hospital in the period from February 2017 to December 2017; 15 patients with pediatric lateral condyle fractures cases operated with open reduction internal fixation by partially serrated 4.0 o. Mean follow up was 6.8 months. Results: we compared our results with the results of the studies in literature, which used screw fixation in management of pediatric lateral condyle fracture. Conclusion: the current follow-up is insufficient to determine whether growth disturbance may be problematic. One other important consideration when screw fixation is utilized is the additional cost of a secondary procedure for screw removal and the medulla of children is small which may lead to the screw crosses the olecranon fossa.

Fixation of Lateral Humeral Condyle by Screw in Children

Background: fractures of the lateral condyle of the humerus represent the second most common type of fracture of the elbow in children. Although this injury is seen at all ages, it is predominately observed in children aged between 5 and 10 years. These injuries are typically the result of an avulsion of a portion of the humeral condyle by pull of the extensor musculature due to a varus force on a supinated forearm or by the direct force of the radial head onto the condyle in the setting of a fall and axial load through an extended elbow. Objective: the purpose of this study was to evaluate the results of fixation of lateral humeral condyle by screw in children by assessment of time to full union, range of motion, and percentage of complications according to Hardacre criteria. Patients and Methods: a randomized prospective interventional study aiming at evaluating of open reduction and fixation of lateral humeral condyle by screw. Our series was conducted in Wadi El- Natroun hospital in the period from February 2017 to December 2017; 15 patients with pediatric lateral condyle fractures cases operated with open reduction internal fixation by partially serrated 4.0 o. Mean follow up was 6.8 months. Results: we compared our results with the results of the studies in literature, which used screw fixation in management of pediatric lateral condyle fracture. Conclusion: the current follow-up is insufficient to determine whether growth disturbance may be problematic. One other important consideration when screw fixation is utilized is the additional cost of a secondary procedure for screw removal and the medulla of children is small which may lead to the screw crosses the olecranon fossa.

Clinical and Radiological Results of Open Reduction and Internal Fixation for the Treatment of Lately Presented Lateral Humeral Condyle Fractures in Children

Clinical and Radiological Results of Open Reduction and Internal Fixation for the Treatment of Lately Presented Lateral Humeral Condyle Fractures in Children

INTER- AND INTRA-OBSERVER AGREEMENT IN THE MILCH AND WEISS SYSTEMS.

ABSTRACTObjective:The aim of this study is to estimate the inter- and intra-observer agreement of the Weiss and Milch classification systems in radiological studies of fractures of the lateral humeral condyle in pediatric patients.Methods:An agreement study was performed with non-probability sampling of consecutive cases with a sample size of a hundred radiological studies, which were evaluated by three experienced orthopedic surgeons and three resident physicians; following a thorough comparison of both inter- and intra-observer agreements over a six-week period based on the Fleiss’ kappa, which was used to determine the inter- and intra-observer agreement rates of both classifications.Results:The overall reliability of the entire group of evaluators for the Milch classification in the inter-observer evaluation was κ = 0.13, 95% CI, 0.08-0.18, and the intra-observer evaluation was κ = 0.08, 95% CI, 0.06-0.11. For the Weiss classification, the overall evaluation had an inter-observer agreement of κ = 0.53, 95% CI, 0.50-0.57, and an intra-observer agreement of κ = 0.22, 95% CI, 0.20 −0.24.Conclusion:In the present study, the Weiss classification system demonstrated greater agreement than the Milch classification; however, the latter may require complementary studies, such as an arthrography to enhance classification accuracy. Level of Evidence II, Diagnostic Studies - Investigating Diagnostic Examination.

Arthroscopically Assisted Surgery for Lateral Humeral Condyle Fractures in Children; Case Series

Arthroscopically Assisted Surgery for Lateral Humeral Condyle Fractures in Children; Case Series

Surgical Results of Posteolateral Approach for Pediatric Lateral Humeral Condyle Fractures

Surgical Results of Posteolateral Approach for Pediatric Lateral Humeral Condyle Fractures

Triple management of cubitus valgus deformity complicating neglected nonunion of fractures of lateral humeral condyle in children: a case series.

Long standing nonunion of the lateral humeral condyle (LHC) usually results in elbow pain and instability with progressive cubitus valgus and tardy ulnar neuritis. Surgical treatment of long standing nonunion is still a controversial issue due to the reported complications, such as stiffness, loss of elbow motion, and avascular necrosis of the LHC fragment. In this study, we reported the outcomes of treatment of cubitus valgus deformity in long standing nonunion of the LHC in children treated with combined triple management (fixation of the nonunion site, dome corrective osteotomy, and anterior transposition of ulnar nerve) through a modified para-triceptal approach. We evaluated tenpatients with cubitus valgus deformity more than 20 degrees after neglected nonunion of the lateral humeral condyle more than 24months. Only childern with post-operative follow up more than 24months were included in this study. All patients were evaluated clinically, radio logically, and by pre- and post-operative functional evaluation using Mayo elbow performance score. For evaluation of ulnar nerve affection, the Akahori's system was used. There were six females and four males with the average age of 7.7years at operation. The left elbow was affected in six patients and the right elbow was affected in four patients. The average time between fracture of the LHC and operation was 40.3months with average post-operative follow up of 44.3months. The average carrying angle of the healthy side was 5.5 degrees and pre-operative carrying angle of the affected side was 33.5 degrees. The average post-operative carrying angle of the affected side was 6.1 degrees. The improvement of the carrying angle at the last follow up was found statistically significant (p < 0.05). All six patients that had pre-operative various degrees of ulnar nerve affection had completely improved at last follow up. The osteotomy site united in an average time of 43days, whereas the LHC nonunion site united in an average time of 77.2days. The osteotomy site united in significantly less time than the LHC non-union site (p < 0.05). The correlation between time since injury and time of union of LHC non-union site was significant (p < 0.05). Post-operative elbow range of motion was not changed in five patients, slightly decreased in four patients, and increased in one patient. Three patients had an average 6.7 degrees (range; 5-10) loss of the last degrees of flexion. One patient developed extension lag of 10 degrees. The mean elbow range of motion (ROM) pre-operatively was 139 ± 4.6 degrees while the mean post-operative ROM was 138 ± 5.3 degrees. The difference was found to be statistically insignificant (p > 0.05). The mean pre-operative Mayo elbow performance score was poor 55 ± 9.7, four patients had fair score, and six had poor score. The mean post-operative Mayo elbow performance score was excellent 92.5 ± 10, six patients had excellent score, and four had good score. The improvement of the Mayo score at the last follow up was found to be statistically significant (p < 0.05). No intra-operative complications were recorded during any of the procedures and no patient developed a wound or pin track infection post-operatively. At the last follow up, none of the patients had developed avascular necrosis of the LHC. Preservation of the blood supply of the nonunited fragment is the key to successful management. This combined technique successfully addresses different aspects of the problem simultaneously and provides a durable solution without deterioration of the results over time. The para-triceptal approach provided excellent exposure of both sides of the elbow with minimal disruption of the triceps muscle.

A 3-Dimensional Analysis of the Fracture Planes in Pediatric Lateral Humeral Condyle Fractures for Image-Based Pin Positioning During Fixation.

To determine the 3-dimensional morphology of pediatric lateral condylar physeal fractures using 3-dimensional computed tomography (3D-CT) and to identify optimal pin positions for percutaneous pinning. Prospective case series of consecutively treated patients. Tertiary university hospital setting. Preoperative 3D-CTs in pediatric surgical candidates diagnosed with lateral condylar physeal fractures. Closed reduction and percutaneous pinning was performed. Reconstructed images of the distal humerus were aligned accordingly to determine the coronal (α), sagittal (β), and axial tilt (γ) angles of the fracture plane. Both α and β were also measured on plain radiography. Image-based position of the 2 pins was calculated preoperatively using 3D-CT, based on anteroposterior and lateral views. Final angle of pins was measured on postoperative radiographs. A total of 29 fractures were assessed. 3D-CT reconstruction images of fractures showed a posterolateral fracture fragment with reference to the long axis of the humerus. The mean α, β, and γ were 62 degrees [95% confidence interval (CI), 59-64], 69 degrees (95% CI, 65-72), and 36 degrees (95% CI, 34-38). Both α and β measured on plain radiography were not significantly different from 3D-CT measurements (P = 0.6712, 0.6218). Average postoperative pin angles were 144 degrees (95% CI, 140-147) and 161 degrees (95% CI, 158-165) for the proximal pin, and 118 degrees (95% CI, 114-122) and 115 degrees (95% CI, 110-120) for the distal pin, on anteroposterior and lateral views, respectively, resulting in similar trajectories to the preoperatively calculated pin positions. Our study adds to the current knowledge by providing an image-based angular reference of the fracture configuration in pediatric lateral humeral condyle fractures, which may be used during percutaneous pinning. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.