Shilu Shrestha1, Richard L Hutchison2. 1. Kirtipur Hospital, Phect-Nepal, Kathmandu, Nepal. 2. BRCA/Blake Medical Centre, 2020 59th St W, Bradenton, FL, 34209, USA.
Abstract
BACKGROUND: Fractures of lateral condyle of humerus are very common in children. While the management of acute displaced and rotated lateral condyle fracture of humerus with early open reduction and internal fixation yields good results, the results of late treatment are less clear. We conducted this study to analyse the results of operative treatment of late presenting fractures and see if it is dependent on the patient's age, fracture type, or the time until treatment. MATERIALS & METHODS: A retrospective study of 40 patients with a symptomatic lateral condyle fracture beyond 3 weeks, who underwent open reduction and internal fixation between January 2002 and December 2011, was conducted. Fractures were described as per Jakob's classification. Patients radiographs were evaluated, and clinical evaluation was done with Mayo elbow scoring and Dhillon scoring system as well as range of motion. RESULTS: Thirty-nine fractures united with average time of 7.8 weeks except one who had previous surgery done for the fracture and developed avascular necrosis. The average Mayo score was 93 and average Dhillon score was 7.6. The average improvement in the arc of motion was 40.32° (77.3-117.6°). Younger age and shorter time to operation had a statistically significant but weak effect on outcomes. CONCLUSIONS: Functional outcomes of fractures managed surgically revealed good results, even in the fractures presenting more than 12 weeks after injury. Families with children presenting late should be offered ORIF to improve function and decrease symptoms.
BACKGROUND: Fractures of lateral condyle of humerus are very common in children. While the management of acute displaced and rotated lateral condyle fracture of humerus with early open reduction and internal fixation yields good results, the results of late treatment are less clear. We conducted this study to analyse the results of operative treatment of late presenting fractures and see if it is dependent on the patient's age, fracture type, or the time until treatment. MATERIALS & METHODS: A retrospective study of 40 patients with a symptomatic lateral condyle fracture beyond 3 weeks, who underwent open reduction and internal fixation between January 2002 and December 2011, was conducted. Fractures were described as per Jakob's classification. Patients radiographs were evaluated, and clinical evaluation was done with Mayo elbow scoring and Dhillon scoring system as well as range of motion. RESULTS: Thirty-nine fractures united with average time of 7.8 weeks except one who had previous surgery done for the fracture and developed avascular necrosis. The average Mayo score was 93 and average Dhillon score was 7.6. The average improvement in the arc of motion was 40.32° (77.3-117.6°). Younger age and shorter time to operation had a statistically significant but weak effect on outcomes. CONCLUSIONS: Functional outcomes of fractures managed surgically revealed good results, even in the fractures presenting more than 12 weeks after injury. Families with children presenting late should be offered ORIF to improve function and decrease symptoms.
Authors: Giovanni Trisolino; Diego Antonioli; Giovanni Gallone; Stefano Stallone; Paola Zarantonello; Piergiuseppe Tanzi; Eleonora Olivotto; Luca Stilli; Giovanni Luigi Di Gennaro; Stefano Stilli Journal: Children (Basel) Date: 2021-01-18