Open Vs. Closed Reduction in Type 2 Lateral Condyle Fractures.

Area of Science:

• Orthopedic surgery
• Pediatric orthopedics
• Traumatology

Background:

• Lateral condyle fractures carry significant risks of nonunion and avascular necrosis (AVN), leading to high morbidity.
• Operative fixation is often required for displaced lateral condyle fractures.
• Comparing reduction techniques is crucial for optimizing patient outcomes and minimizing complications.

Purpose of the Study:

• To compare the clinical outcomes of closed reduction versus open reduction techniques for operative lateral condyle fractures.
• To evaluate differences in operative time, complication rates, and radiographic parameters between the two methods.

Main Methods:

• A retrospective review of all operative lateral condyle fractures over a ten-year period.
• Comparison of closed reduction versus open reduction groups based on operative time, infection rate, AVN, nonunion, physeal closure, and radiographic measurements (ulnohumeral angle, interepicondylar width).

Main Results:

• The closed reduction group had significantly less displacement (3.95mm vs. 9.47mm) and shorter operating room time (average 45 minutes less).
• Closed reduction also resulted in significantly fewer postoperative admissions.
• No significant differences were observed in infection rates, AVN, nonunion, or radiographic outcomes between the groups.

Conclusions:

• Closed reduction is associated with decreased operating room time and fewer postoperative admissions, suggesting it as a preferred method from a quality improvement perspective.
• Both closed and open reduction techniques yield similar rates of major complications like nonunion and AVN.
• Further research may explore patient selection criteria to optimize outcomes for each technique.