Çelik Orhun, Ertürk Cemil, Elmas Yunus
Department of Orthopedic Surgery and Traumatology, Istanbul Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
J Pediatr Orthop B. 2025 Mar 1;34(2):117-123. doi: 10.1097/BPB.0000000000001202. Epub 2024 Aug 30.
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.
小儿肱骨外侧髁骨折(PHLCF)是儿童中最常见的骨折之一。PHLCF约占所有小儿肘部骨折的20%。治疗方式包括:夹板非手术治疗、经皮克氏针内固定闭合复位(CRPP)以及克氏针内固定切开复位(ORIF)。我们旨在评估采用CRPP或ORIF治疗的Jakob 2型PHLCF的放射学、功能和临床结果。我们假设对于Jakob 2型PHLCF,CRPP可能与ORIF一样安全有效。在这项回顾性研究中,我们纳入了在单一中心接受手术治疗的Jakob 2型PHLCF患者。多发性骨折或开放性骨折患者被排除在研究之外。纳入了69名年龄在2至12岁之间的患者,并将他们分为两组。第1组包括接受CRPP治疗的患者,而第2组包括接受ORIF治疗的患者。对人口统计学、放射学、临床和功能参数进行了评估。第1组的平均手术时间(P < 0.001)、初始移位(P = 0.014)和住院时间(P < 0.001)明显更短。第2组左侧损伤的百分比明显高于第1组(P = 0.038)。第1组的平均内翻畸形评分明显更高(P = 0.014)。CRPP与较短的手术时间和住院时间相关。对于Jakob 2型PHLCF,CRPP和ORIF在功能、临床和放射学结果方面相似。对于Jakob 2型PHLCF,CRPP可能与ORIF一样安全有效。