Eckhoff Michael D, Tadlock Josh C, Nicholson Tyler C, Wells Matthew E, Garcia EStephan J, Hennessey Theresa A
Department of Orthopedics, William Beaumont Army Medical Center, El Paso, TX, USA.
Department of Pediatric Orthopedics, Shriner's Hospital for Children, Salt Lake City, UT, USA.
Shoulder Elbow. 2022 Jun;14(3):317-325. doi: 10.1177/17585732211010299. Epub 2021 Apr 22.
Lateral condyle fractures are the second most common pediatric elbow fracture. There exist multiple options for internal fixation including buried K-wires, unburied K-wires, and screw fixation. Our study aims to review the current literature and determine if fixation strategy affects outcomes to include fracture union, postoperative range of motion, and need subsequent surgery.
A systematic review of Pubmed, MEDLINE, and EMBASE databases was performed. Included articles involve pediatric patients with displaced lateral condyle fractures treated with internal fixation that reported outcomes to include union rates and complications.
Thirteen studies met inclusion criteria for a total of 1299 patients (472 buried K-wires, 717 unburied K-wires, and 110 screws). The patients' average age was 5.8 ± 0.6 years, male (64%), and had 16.3 months of follow-up. No differences in union and infection rates were found. Unburied K-wires had the shortest time to union and the greatest elbow range of motion postoperatively.
Our systematic review demonstrates similar outcomes with union and infection rates between all fixation techniques. Unburied K-wires demonstrated a shorter time to union and the greatest postoperative range of motion. Additionally, unburied K-wires may be removed in clinic, decreasing the cost on the healthcare system.
Level 3.
外侧髁骨折是儿童肘部第二常见的骨折。内固定有多种选择，包括埋头克氏针、非埋头克氏针和螺钉固定。我们的研究旨在回顾当前文献，并确定固定策略是否会影响骨折愈合、术后活动范围及后续手术需求等结果。
对PubMed、MEDLINE和EMBASE数据库进行系统综述。纳入的文章涉及接受内固定治疗的移位性外侧髁骨折的儿科患者，这些文章报告了包括愈合率和并发症在内的结果。
13项研究符合纳入标准，共1299例患者（472例使用埋头克氏针，717例使用非埋头克氏针，110例使用螺钉）。患者的平均年龄为5.8±0.6岁，男性占64%，随访时间为16.3个月。未发现愈合率和感染率有差异。非埋头克氏针的愈合时间最短，术后肘部活动范围最大。
我们的系统综述表明，所有固定技术在愈合率和感染率方面的结果相似。非埋头克氏针的愈合时间较短且术后活动范围最大。此外，非埋头克氏针可在门诊取出，降低了医疗系统的成本。
3级。
