Abstract
Introduction The treatment of the displaced fracture of the lateral condyle of the distal humerus
in children aims not only to avoid nonunion, malalignment, and impairment of the range
of motion of the elbow but also to prevent delayed healing and the development of
any prearthrotic deformity. To date there is no agreement on what kind of osteosynthesis
should be used. So far, the screw fixation and Kirschner wire fixation have both been
applied. Therefore, the goal of this study was to compare the outcome of these two
methods.
Materials and Methods A retrospective cohort study was undertaken including 43 patients aged 2 to 13 years
who underwent osteosynthesis for a condylar fracture of the humerus over a period
of 10 years. The electronic archive, including the radiological diagnostics, was analyzed.
Statistical analysis was performed using IBM SPSS Statistics 20.0. Statistical significance
was set at an α level of p = 0.05.
Results Kirschner wire fixation was performed in 48.9% of condylar fractures of the humerus
while screw fixation (alone or in combination with a pin) was assessed with a percentage
of 51.1% of the cases in this study. Screw fixation only was applied in 20.9% of fractures
of the lateral condyle. The selection of the method was independent of the age of
the patient (p = 0.2). The comparison of the rate of complications and an impaired range of motion
after Kirschner wire osteosynthesis to the rate after screw osteosynthesis showed
a significantly lower percentage for the Kirschner wire group (p = 0.046). No case of nonunion, nerve palsy, or pin migration was detected in any
patient in this study.
Conclusion Kirschner wire fixation of condylar humeral fractures in children resulted in a lower
rate of complications than screw fixation. No case of nonunion of the fracture was
found in the patients that we investigated so that we conclude that Kirschner wires
sufficiently adapt the fracture in these cases.
Level of Evidence Level III.
Keywords
screw fixation - pin fixation - children - lateral condyle fracture of the humerus
