Infection and Nonunion Following Operative Treatment of Lateral Humeral Condyle Fractures

Area of Science:

• Orthopedic surgery
• Pediatric orthopedics
• Traumatology

Background:

• Lateral humeral condyle fractures (LHCF) are common pediatric elbow injuries.
• This study examines infections and nonunions in surgically treated LHCF.
• It represents the largest case series on these complications to date.

Purpose of the Study:

• To characterize the incidence and management of infections following LHCF surgery.
• To characterize the incidence and management of nonunions following LHCF surgery.
• To analyze the impact of these complications on patient treatment timelines and healthcare utilization.

Main Methods:

• Retrospective review of pediatric patients with LHCF treated surgically from 2012-2022.
• Inclusion criteria: patients diagnosed with active infection or nonunion post-surgery.
• Data collected: demographics, treatment, presentation, interventions, outcomes, and timing.

Main Results:

• 1.4% of patients (12/863) developed 13 infections (cellulitis, soft tissue infection, osteomyelitis).
• 1.2% of patients (10/863) developed nonunion, primarily Weiss type II and III fractures.
• Infections averaged 29 days post-op; nonunions averaged 12 weeks post-op. One osteomyelitis case resulted in nonunion.

Conclusions:

• Infection and nonunion are infrequent but significant complications of pediatric LHCF surgery.
• Infections often necessitate admission, antibiotics, and potentially further surgery.
• Nonunions require prolonged immobilization, surgical repair, and intensive rehabilitation.