Comparative Outcomes of Early, Elective, and Delayed Treatment for Lateral Condyle Fracture of the Humerus in...

Area of Science:

• Pediatric Orthopedics
• Trauma Surgery
• Elbow Fractures

Background:

• Lateral condyle fractures of the humerus in children require prompt diagnosis and treatment to prevent malunion and varus deformity.
• The COVID-19 pandemic caused significant delays in pediatric orthopedic care globally.
• This study investigates outcomes of early, elective, and delayed treatment for these fractures.

Purpose of the Study:

• To compare treatment outcomes for pediatric lateral condyle humerus fractures based on timing of intervention (early, elective, delayed).
• To evaluate the impact of treatment delays on fracture union, complications, and functional scores.
• To provide insights into managing these fractures during public health emergencies.

Main Methods:

• Retrospective analysis of 140 pediatric patients with Milch type 2 lateral condyle humerus fractures (2013-2021).
• Patients underwent surgical fixation (K-wires or screws) after open or closed reduction.
• Outcomes assessed via clinical examination, X-rays, Mayo Elbow Performance Score (MEPS), and monitoring of complications.

Main Results:

• Significant differences in surgery duration and incision size were observed between early, elective, and delayed treatment groups.
• Mayo Elbow Performance Scores (MEPS) differed significantly between early/delayed and early/elective groups.
• While complications increased with delayed treatment, functional outcomes remained comparable.

Conclusions:

• Surgical treatment for late-presenting pediatric lateral condyle humerus fractures does not necessarily lead to worse outcomes despite increased complications.
• Maintaining standardized fracture management protocols is crucial, even during challenging periods like the COVID-19 pandemic.
• This highlights the resilience of surgical intervention for pediatric elbow fractures regardless of presentation timing.