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Percutaneous K wire fixation in pediatric lateral condylar fractures of humerus: A prospective study
1Department of Orthopedics, School of Medical Sciences & Research, Sharda University, Greater Noida, Uttar Pradesh, India.
Insights
K-wire fixation effectively treats displaced lateral condyle humerus fractures in children, achieving excellent functional outcomes. Open reduction is advised for displacements over 2mm.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Traumatology
Background:
- Displaced lateral condyle humerus fractures are common in children.
- K-wire fixation is a surgical option for these fractures.
Purpose of the Study:
- To evaluate radiographic and clinical functional outcomes of K-wire fixation for displaced lateral condyle humerus fractures in children.
Main Methods:
- Prospective longitudinal study of 85 children (mean age 7.76 years) with displaced (>2mm) lateral condyle humerus fractures.
- Treatment involved closed reduction and internal fixation with two K-wires for three weeks.
- Fracture classification by Milch and Badelon; functional results evaluated by Hardacre et al. criteria; mean follow-up 24 months.
Main Results:
- All fractures achieved union in a mean of 3 weeks.
- Excellent functional results (91.75%) and good results (7.05%) were reported.
- Full elbow range of motion achieved; no instability. Superficial pin tract infection in 5.88%.
Conclusions:
- Percutaneous K-wire fixation is effective for unstable, displaced lateral condylar humerus fractures in children.
- Open reduction and internal fixation recommended for fractures with >2mm displacement after closed reduction.
Background:
We evaluated the radiographic and clinical functional results of K-wire fixation in the treatment of displaced lateral condyle fractures of the humerus.
Materials And Methods:
A prospective longitudinal study was undertaken in our hospital during the period December 2010-December 2014. A total number of 85 children (18 girls and 67 boys) mean age 7.76 years; range 2-13 years with displaced (>2mm) lateral condyle fractures of the humerus. All the patients were treated by close reduction and internal fixation with two K-wires for three weeks. The fractures were classified according to the criteria by Milch and Badelon and functional results were evaluated according to the criteria by Hardacre et al. The mean follow-up period was 24 months (range: 20-28 months).
Results:
All children achieved union in a mean time of 3 weeks (range: 2.5-6 weeks). Functional results were excellent in 91.75% children and good in 7.05% children. Full range of elbow motion was achieved in all the patients. None of the patients had instability postoperatively. Post-operatively, 5.88% children got pin tract infection, which was superficial and healed after removing pins and oral antibiotic administration.
Conclusion:
Percutaneous K-wire fixation is an effective treatment for unstable displaced lateral condylar fractures of the humerus in children. If fracture displacement after closed reduction exceeds 2mm, open reduction and internal fixation is recommended.
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