Pediatric Lateral Condyle Fractures Pins or Screw?

Area of Science:

• Orthopedic Surgery
• Pediatric Orthopedics
• Trauma Surgery

Background:

• Pediatric lateral condyle elbow fractures are common.
• Operative fixation is often required for displaced fractures.
• Comparing fixation methods is crucial for optimal outcomes.

Purpose of the Study:

• To compare clinical, radiographic, and functional outcomes of pin versus screw fixation for pediatric lateral condyle elbow fractures.
• To determine if screw fixation is non-inferior to pin fixation.

Main Methods:

• Prospective observational cohort study of skeletally immature patients (<18 years) with Weiss type 2 and 3 lateral condyle fractures.
• Patients received either pin or screw fixation.
• Non-inferiority analytical framework used for comparison.

Main Results:

• No significant difference in time to radiographic union or complication rates between pin and screw fixation.
• Screw fixation group had a mean of 8 fewer days in cast immobilization.
• Two cases of nonunion and two of avascular necrosis occurred in the pin fixation group; none in the screw group.

Conclusions:

• Screw fixation is non-inferior to pin fixation for pediatric lateral condyle elbow fractures.
• Screw fixation allows for faster cast removal without compromising union time or range of motion.
• While complication rates were similar, screw fixation avoided specific complications like nonunion seen with pins.