Comparison of radiological, clinical, and functional results of Jakob type 2 lateral condyle fractures treated with closed reduction and percutaneous pinning versus open reduction and K-wire fixation.

Abstract

Pediatric humerus lateral condyle fractures (PHLCF) are one of the most common fractures among children. PHLCF is approximately 20% of all pediatric elbow fractures. Among the treatment modalities are: nonoperative treatment with splinting, closed reduction with percutaneous K-wire fixation (CRPP), and open reduction with K-wire fixation (ORIF). We aimed to evaluate radiological, functional, and clinical outcomes of Jakob type 2 PHLCF treated either with CRPP or ORIF. We hypothesized that CRPP may be as safe and effective as ORIF for Jakob type 2 PHLCF. In this retrospective study, we included patients with Jakob type 2 PHLCF operatively treated in a single center. Patients with multiple fractures or open fractures were excluded from the study. 69 patients between ages 2 and 12 were included and they were divided into two groups. Group 1 included the patients treated with CRPP, whereas Group 2 included the patients treated with ORIF. Demographical, radiological, clinical, and functional parameters were evaluated. Average duration of surgery ( P  < 0.001), initial displacement ( P  = 0.014), and duration of admission ( P  < 0.001) were significantly less in group 1. Group 2 had significantly higher percentage of left-sided injury than group 1 ( P  = 0.038). Average varus deformity score was significantly higher in group 1 ( P  = 0.014). CRPP was associated with shorter duration of surgery and hospital stay. Functional, clinical, and radiological outcomes were identified similar between CRPP and ORIF for Jakob type 2 PHLCF. CRPP may be as safe and effective as ORIF for Jakob type 2 PHLCF.