Sapkota Hari Prasad, Rokaya Poojan K, Rawal Mangal, Karki Dhan Bahadur, Limbu Deoman
Department of Orthopedics, Mid-Western Regional Hospital, Surkhet, Nepal.
Department of Orthopedics, Karnali Academy of Health Sciences, Jumla, Nepal.
Open Orthop J. 2018 Jun 29;12:229-235. doi: 10.2174/1874325001812010229. eCollection 2018.
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 late removal of internally fixated Kirschner's wires for displaced lateral condyle fracture of distal humerus.
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.
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 ( = 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 (=0.724) and 6 months (=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 ( = 0.106).
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.
肱骨远端外侧髁骨折是儿童肘部第二常见的骨折。不稳定、旋转和移位（>2mm）的骨折采用克氏针或螺钉切开复位内固定治疗。对于内固定后克氏针应在位放置多长时间仍存在争议。我们旨在比较早期和晚期取出内固定克氏针治疗肱骨远端外侧髁移位骨折后的功能和影像学结果。
对肱骨外侧髁移位骨折切开复位内固定后早期（3-4周）或晚期（5-7周）取出克氏针的儿童进行至少6个月的观察。评估并比较早期和晚期组的放射学愈合时间、提携角、活动范围。使用Dhillon评分系统比较功能结果。
我们报告了40例病例的结果（早期和晚期组各20例）。两组所有病例在随访12周时均实现放射学愈合。早期和晚期组之间提携角的平均丢失在统计学上无显著差异（P = 0.394）。在随访12周（P = 0.724）和6个月（P = 0.638）时，早期和晚期组在活动弧方面无显著差异。使用Dhillon评分系统，早期组Dhillon评分100%为优秀，晚期组80%为优秀，20%为良好。两组之间的功能结果在统计学上无显著差异（P = 0.106）。
儿童肱骨外侧髁移位骨折早期取出内固定克氏针与晚期取出显示出相似的放射学和功能结果。
