A Comprehensive Analysis of Complications in Pediatric Lateral Humeral Condyle Fractures.

Abstract

Complications such as subsequent displacement and non-union in children with non-displaced or minimally displaced lateral humeral condyle fractures (LHCF) may happen. We aim to identify potential prognostic factors that could influence the outcomes of these fractures. A retrospective study in a level I trauma center was performed. The patient data included demographics, injured side, fracture displacement, treatment, and the occurrence of subsequent displacement, non-union, or other complications. Fractures were classified according to the Jakob's classification, relying on simple radiographs, and displacement was quantified in millimeters using anteroposterior (AP) and lateral views. The study sample comprised 89 children (80% Jakob I and 20% Jakob II). The mean age at the time of injury was 6 (3). Treatment was non-surgical in 81% of cases, while 19% received surgery. 24 patients (27%) experienced complications. Correlational analyses revealed that a higher degree of initial displacement showed significant associations with non-union, lateral condyle hypertrophy, and alignment disturbance. Predictive performance analysis indicated that displacement exceeding 1.5 mm should be surgically treated. Following non-displaced or minimally displaced LHCF, our study revealed an 8% occurrence of subsequent displacement and a 2% rate of non-union. An association between the initial degree of fracture displacement and the occurrence of non-union, lateral condyle hypertrophy, and alignment disturbances was observed. Fractures exhibiting displacement greater than 1.5 mm might be deemed appropriate for surgical intervention. IV.