scholarly journals Comparison of Kirschner wires and Cannulated screw internal fixation for displaced lateral humeral condyle fracture in children

2019 ◽  
Vol 10 (6) ◽  
pp. 75-79
Author(s):  
Pabin Thapa ◽  
Krishna Sapkota ◽  
Krishna Wahegaonkar ◽  
Niraj Ranjeet ◽  
Pratyenta Raj Onta ◽  
...  
Keyword(s):  
Internal Fixation ◽  
P Value ◽  
Lateral Condyle ◽  
Kirschner Wires ◽  
Lateral Condyle Fracture ◽  
The Mean ◽  
K Wires ◽  
Condyle Fracture ◽  
Humeral Condyle ◽  
Screw Group

Background: Lateral condyle fracture of the distal humerus is the second most common injury around the elbow. Aims and Objective: The purpose of the study was to compare Kirschner wires (K-wire) and Cannulated cancellous (CC) screw for internal fixation of displaced lateral humeral condyle fracture in children. Materials and Methods: Forty-six patients with a displaced lateral condyle fracture of humerus were included in the study. Patients were treated with open reduction and internal fixation either with two 1.8mm K-wires or one 4mm CC screw. Fractures were classified according to Milch classification and clinical outcomes were evaluated according to criteria of Hardacre et al. Results: There were 23 patients in each group with the mean age of 6.57 years (range 2 to 12 years). Milch type II was common (n= 34) than Milch type I (n=12). Fracture union was observed at mean 4.13 weeks in the CC screw and 4.61 weeks in K-wire group.(p value = 0.026). On an average the CC screws were removed at 13.57 weeks and K-wires were at 4.57 weeks. The mean follow-up was 13.83 months in CC screw and 12.52 months K-wire group. Three patients (6.5%) had superficial pin site infection and 2 patient (4.3%) had lateral condyle prominence in the K-wire group and only one lateral condyle prominence (2.2%) was observed in the CC screw group. According to the Hardacre et.al criteria CC screw group were excellent in 20 (87%) and good in 3 (13%) patients whereas 13 (56.5%) excellent and 10 (43.5%) good results were found in the K-wire group. (p value = 0.022). Conclusion: Open reduction and internal fixation with either K-wires or cannulated cancellous screw for displaced lateral condyle fracture of humerus are both effective treatment methods but screw fixation provides absolute stability at the fracture site enhancing the fracture healing, reduces the probability of lateral prominence and allows early range of motion and activity in the affected elbow.

scholarly journals Comparison of radiological and clinical outcome among Kirschner wires versus 3.5 mm diameter cannulated cancellous screw internal fixation in treatment for the displaced lateral humeral condyle fractures in children

2021 ◽  
Vol 7 (2) ◽  
pp. 219
Author(s):  
Lokpal Singh Bhati ◽  
Ashish Kumar Gupta ◽  
Jitendra Singh Rathor ◽  
Devendra Singh Rathore ◽  
Deepak Kundu
Keyword(s):  
Screw Fixation ◽  
Lateral Condyle ◽  
Cancellous Screw ◽  
Kirschner Wires ◽  
Fractures In Children ◽  
High Incidence ◽  
K Wires ◽  
Condyle Fracture ◽  
Humeral Condyle ◽  
Written Informed Consent

<p><strong>Background:</strong> Lateral humeral condyle fracture, the second most common injury around the elbow, accounts for 10-20% of all fractures of the elbow in children with a high incidence between two and 14 years.</p><p><strong>Methods:</strong> This hospital based prospective randomized comparative study design was include patients of both sexes in age group of 2 to 14 years attending SMS hospital, Jaipur during April 2018 to June 2019 or till the sample size achieved, with due permission from the institutional ethic committee and review board and after taking written informed consent from the patient.</p><p><strong>Results:</strong> 40 patients out of 50 were grouped as excellent (70.1%) while 13 were found good (22.8%) and only four patients were found poor (7.01%) as per Hardacre criteria of assessment of lateral condyle treatment in k wire group while excellent, good and poor results were found 68.4, 24.5 and 7.01% respectively in CC screw groups</p><p><strong>Conclusions:</strong> The displaced fractures (displacement over 2 mm) can be treated successfully by open reduction and K-wires or screw fixation with excellent results.</p><p> </p>

scholarly journals Outcome of Lateral Condyle Fracture of Humerus in Children Treated with Open Reduction and Internal Fixation

2019 ◽  
Vol 17 (2) ◽  
pp. 17-20
Author(s):  
Dipendra K.C. ◽  
S.M. Mishra ◽  
Sushil Yogi ◽  
Dinesh Shrestha ◽  
Prateek Karki ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
College Teaching ◽  
Implant Removal ◽  
Lateral Condyle ◽  
Type I ◽  
Age Group ◽  
Lateral Condyle Fracture ◽  
K Wires ◽  
Condyle Fracture

Introduction: Lateral condyle fracture is one of the commonest injuries encountered in pediatric age group. There is no unanimity regarding the method of treatment, however closed reduction is not applicable to all cases and have failure rates making open reduction and internal fixation (ORIF) as the treatment of choice at least in displaced fractures. There are a number of options during surgical management of these fractures; Kirschner-wire (K-wire) is the most commonly used implant for fixation. The purpose of our study was to evaluate the results of lateral condyle fractures of humerus in children treated by ORIF by K-wires based on Hardacre criteria. Materials: This prospective study was conducted in the department of orthopedics in Nepalgunj Medical College Teaching Hospital, Kohalpur from May 2016 to October 2018. All of the fractures in this study were treated by ORIF with unburied K-wires. It included 37 children of age group upto 14 years. Children were evaluated for age, sex, side of arm involved, mechanism of injury, type of fracture, presence of additional injuries, implant removal time, outcome and accompanying complications. K-wires were removed after clinico-radiological union of the fractures. Patients were evaluated using the Hardacre criteria in follow up till 6 months. Result: In this study of 37 children, 28 (75.7%) were males and 9 (24.3%) were females. All of them were 14 years of age or less with mean age of 6.7 ± 0.316. Majority of fractures (67.6%) were observed between six to ten years of age. Left side was predominantly involved (62.2%). Milch type I fracture was found in 5 (13.5%) children while Milch type II fracture were observed in 32 (86.5%) children. The final outcome and functions were evaluated using Hardacre criteria in which 27 (73%) cases had excellent result and all cases had good result as per Hardacre criteria. The complications were 10 (27%) cases of lateral spur; eight (21.6%) cases of hypertrophied scar and four (10.8%) cases of pin track infection and 2 (5.4%) of cubitus varus. Conclusion: The treatment of displaced lateral condyle fracture of humerus by open reduction and unburied K-wire fixation is safe, easy and cost effective procedure with good results. This modality of treatment provides good results among pediatric population without the need for second admission for implant removal.  

scholarly journals Paediatric lateral humeral condyle fractures managed by k-wire fixation, should the wires be buried or left exposed: a dilemma

2020 ◽  
Vol 7 (1) ◽  
pp. 78
Author(s):  
Nitin Choudhary ◽  
Sanjeev Gupta ◽  
Neeraj Mahajan ◽  
Rahul Mahajan ◽  
Amar Saharan
Keyword(s):  
Exposed Group ◽  
Lateral Condyle ◽  
Risk Of Infection ◽  
Union Rate ◽  
Kirschner Wires ◽  
Major Procedure ◽  
Carrying Angle ◽  
K Wires ◽  
A Prospective Study ◽  
Humeral Condyle

<p><strong>Background:</strong> Fractures of the lateral condyle of the humerus in children are common injuries. If displaced or unstable they may require surgical reduction and fixation with Kirschner wires (K-wires). These may be passed through the skin and left exposed or buried subcutaneously.</p><p><strong>Methods:</strong> A prospective study was carried out in department of orthopaedics at my college from January 2019 to March 2020.  A total number of 37 subjects were included in the study.</p><p><strong>Results:</strong> Patients were followed for a period of 3 months and results were drawn on basis of union, infection, carrying angle at the elbow, and range of motion (ROM) which was assessed by clinico-radiological means.</p><p><strong>Conclusions: </strong>Buried wire group has shown better union rate than exposed group, wires could be removed under local anaesthesia thereby avoiding any major procedure and also the risk of infection is low making this a better option than the exposed cohort.</p>

scholarly journals Complications of Lateral Humeral Condyle Fractures in Children

2021 ◽  
Vol 7 (2) ◽  
Keyword(s):  
Treatment Options ◽  
Delayed Union ◽  
Lateral Condyle ◽  
Fractures In Children ◽  
Lateral Condyle Fracture ◽  
Fishtail Deformity ◽  
Spur Formation ◽  
Condyle Fracture ◽  
Internal Oblique ◽  
Humeral Condyle

Lateral humeral condyle fractures in children are easily missed and often associated with complications. These complications include malunion, delayed union or nonunion, lateral spur formation, fishtail deformity and growth disturbances. There is also controversy related to best treatment options including closed vs open reduction and K-wire vs screw fixation. Though some complications like malunion are avoidable, others like lateral spur formation are inevitable. Knowledge about these complications would help in counseling patients and their families. The purpose of this article was to review common complications related to these fractures and suggest tips to avoid some of them. Keywords: Paediatric, Lateral condyle fracture, Internal oblique X-ray, Arthrogram, Anatomical reduction, Complications, Tips to overcome

scholarly journals Early Versus Late Removal of Internally Fixated Kirschner’s Wires for Displaced Lateral Condyle Fracture of Humerus in Children

2018 ◽  
Vol 12 (1) ◽  
pp. 229-235
Author(s):  
Hari Prasad Sapkota ◽  
Poojan K Rokaya ◽  
Mangal Rawal ◽  
Dhan Bahadur Karki ◽  
Deoman Limbu
Keyword(s):  
Internal Fixation ◽  
Scoring System ◽  
Distal Humerus ◽  
Lateral Condyle ◽  
Lateral Condyle Fracture ◽  
Carrying Angle ◽  
Condyle Fracture ◽  
Late Group ◽  
Radiological Union

Introduction: Lateral condyle fracture of the distal humerus is the second most common paediatric elbow fracture. Unstable, rotated and displaced (>2 mm) fractures are managed with open reduction and internal fixation with Kirschner’s wires or screws. Debate persists as for how long the Kirschner’s wires should be placed in situ after internal fixation. We aimed to compare the functional and radiological outcome after early versus late removal of internally fixated Kirschner’s wires for displaced lateral condyle fracture of distal humerus. Methods: Children that underwent early (3-4 weeks) or late (5-7 weeks) removal of Kirschner’s wire after open reduction and internal fixation for displaced lateral condyle fracture of humerus were observed for a period of minimum 6 months. Time to radiological union, carrying angle, range of motion was assessed and compared between early and late group. Functional outcome was compared using the Dhillon scoring system. Results: We report the outcome of 40 cases (20 cases in each early and late group). Radiological union was achieved in all the cases of both group at 12 weeks follow up. The mean loss of carrying angle was statistically insignificant (p = 0.394) between the early and late group. There was no significant difference between the early and late group in relation to arc of motion at 12 weeks (p=0.724) and 6 months (p=0.638) follow up. Using the Dhillon scoring system, there was 100% excellent Dhillon score in early group, 80% excellent and 20% good Dhillon score in late group. Functional outcome was statistically insignificant between the two groups (p = 0.106) Conclusion: Early removal of internally fixated K-wires for displaced lateral condyle fracture of humerus in children showed similar radiological and functional results to late removal.

scholarly journals Operative Management of late Presented Displaced Lateral Condyle Fracture of Humerus in Children

2018 ◽  
Vol 56 (209) ◽  
pp. 527-530 ◽  
Author(s):  
Rajendra Sanjel Chhetri ◽  
Indra Dhakal ◽  
Gopal Gnawali
Keyword(s):  
Range Of Motion ◽  
Avascular Necrosis ◽  
Conservative Management ◽  
Operative Management ◽  
Lateral Condyle ◽  
Kirschner Wires ◽  
Fracture Union ◽  
Lateral Condyle Fracture ◽  
Condyle Fracture ◽  
Displaced Fracture

Introduction: Management of late presented displaced fracture of lateral condyle of humerus in children is controversial, many recommend conservative management due to fear of complications like avascular necrosis but recently many are advocating for operative management with good results hence we studied the outcome of operative management in late presented displaced lateral condyle fracture of humerus in children. Methods: We studied 22 children aged between 4 to 11 years, presenting 3 to 16 weeks from injury. All underwent open reduction and internal fixation with Kirschner wires with or without additional screw and followed up for average 18.05 months. Elbow range of motion, angular or local deformity, premature fusion of physis, avascular necrosis and fracture union were noted and analyzed using modified Aggarwal et al criteria. Results: We had 9 (40.91%) excellent, 5 (22.73%) good, 5 (22.73%) fair, 3 (13.63%) poor result. Overall satisfactory results were seen in 19 (86.37%); 3 (13.63%) had poor result , one due to AVN, two due to premature fusion of physis and visible local deformity. All poor result were seen among delay of operation 6 weeks or later. There was significant improvement of elbow range of motion and all fracture united. Conclusions: Outcome of operation without bone grafting on lateral condyle fracture of humerus in children who presents late up to 5 weeks are excellent; whereas outcome of delayed operation up to 16 weeks also gives good functional recovery and union.

Open reduction of pediatric lateral condyle fractures: a systematic review

2021 ◽  
pp. 175857322110102
Author(s):  
Michael D Eckhoff ◽  
Josh C Tadlock ◽  
Tyler C Nicholson ◽  
Matthew E Wells ◽  
EStephan J Garcia ◽  
...  
Keyword(s):  
Systematic Review ◽  
Internal Fixation ◽  
Range Of Motion ◽  
Lateral Condyle ◽  
Elbow Fracture ◽  
Infection Rates ◽  
Fixation Techniques ◽  
K Wires ◽  
Pediatric Elbow Fracture ◽  
The Cost

Introduction Lateral condyle fractures are the second most common pediatric elbow fracture. There exist multiple options for internal fixation including buried K-wires, unburied K-wires, and screw fixation. Our study aims to review the current literature and determine if fixation strategy affects outcomes to include fracture union, postoperative range of motion, and need subsequent surgery. Methods A systematic review of Pubmed, MEDLINE, and EMBASE databases was performed. Included articles involve pediatric patients with displaced lateral condyle fractures treated with internal fixation that reported outcomes to include union rates and complications. Results Thirteen studies met inclusion criteria for a total of 1299 patients (472 buried K-wires, 717 unburied K-wires, and 110 screws). The patients’ average age was 5.8 ± 0.6 years, male (64%), and had 16.3 months of follow-up. No differences in union and infection rates were found. Unburied K-wires had the shortest time to union and the greatest elbow range of motion postoperatively. Conclusions Our systematic review demonstrates similar outcomes with union and infection rates between all fixation techniques. Unburied K-wires demonstrated a shorter time to union and the greatest postoperative range of motion. Additionally, unburied K-wires may be removed in clinic, decreasing the cost on the healthcare system. Evidence Level 3.

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