EC Paediatrics

Background: Lateral condyle humeral fractures are relatively common in developing regions of the world. Lateral condyle humeral fractures in the pediatric age group, most commonly distal humeral head injuries, are often associated with late presentation to medical professionals at the end of the course.

Materials and Methods: Twenty-one children with lateral condyle humeral fractures with a duration of injury 1-3 weeks and greater than 3 weeks were included in a prospective study. Of the 21 patients, 14 were male and 7 were female. All patients had Milch type II injuries. Patients were treated with open reduction and internal fixation with Kirschner wires. The outcome was assessed using the scoring system proposed by Dhillon., et al.

Results: Mean age (months) at surgery was 81.5 months (range 64-112 months); 8 right/13 left; Reason for admission: Pain, swelling in 12 patients; Pain, Decreased elbow mobility in 7 patients, Stiffness of elbow joint in 2 patients. Mean time from fracture to surgery was 6.34 weeks; ≤ 3 weeks in 13 patients and > 3 weeks in 8 patients; Previous treatment: Casting in 15 patients and No treatment in 6 patients; Mean follow-up time: 66 months; Mean age at last follow-up was 11.6 years (range 8.4-15.0). Overall results: Total result, 38.1% in Excellent, 38.1% in Good, 14.3% in Fair, and 9.5% in Poor. Comparative results were accepted at ≤ 3 weeks initial fracture to surgery and > 3 weeks with PValuate 0.001387. There was 1 case of AVN, and Nonunion in 1 case.

Conclusion: Kirschner wire fusion without bone grafting can provide a secure bone union and improve elbow function. However, this technique cannot completely prevent angular deformity. Orthopedic surgery should be considered in patients with valgus or varus deformity.

 Keywords: Late Presentation; Lateral Epicondyle Fracture; Acute Operation; Surgical Technique; Surgical Management

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