Pining Fixation Versus Canulated Screw with Open Reduction of Pediatric Lateral Condyle Humerus Fractures

Document Type : Original Research Papers

Authors

1 Orthopedic Surgery Dept., El- Sahel teaching hospital , Cairo, Egypt

2 Orthopedic surgery Dept., Faculty of Medicine, Benha Univ., Benha, Egypt

Abstract

Good results have been described for lateral condyle Fractures pediatrics treated by open reduction and fixation using
Kirschner wires or screws.We, in our level III retrospective comparison clinical research study, retrospectively reviewed 20
patients (10 K-wire, 10 screw fixation; average age 5.6 years, average follow-up 6.8 months). The clinical outcomes were
evaluated according to the criteria of Hardacre et al. There was no statistically significant difference in clinical outcome
between these two groups. Two patients developed skin infection around K-wires, while no infection occurred in fracture with
screws. An obvious lateral prominence occurred in one patient with K-wires and none with screws. One patient with K-wires
and one patient with screws had a lack of 15° of extension of the elbow compared with the other side. With K-wires there
were two nonunions (average time to union 9.6 weeks). With screws, one nonunions (average of 6.8 weeks). Both K-wires and
cannulated screw fixation are effective in treatment for lateral humeral condyle fracture. K-wires can pass through the ossific
nucleus of capitulum without damaging it, but a longer period of external fixation and local skin care will be required. Screw
fixation patients spent fewer days in a cast and had agreater range of motion at the last follow-up. Screw fixation is associated
with fewer nonunions and faster time to union, but a secondary procedure for removal is required .

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