In Situ Late Metaphyseal Osteosynthesis for the Fractures of the Lateral Humeral Condyle in Children

PURPOSE: To evaluate the efficacy of the in situ late osteosynthesis for slightly displaced fractures of the lateral humeral condyle. MATERIALS AND METHODS: From 2000 to 2004, 12 patients (8 boys and 4 girls) were managed with in situ late osteosynthesis for fractures of the lateral humeral condyle. The average age at the time of operation was 6 years 1 month (1 year 7 months~9 years 1 month), and the mean amount of fragment displacement was 3.3 mm (2.0~4.5 mm). The operative procedure included curettage and in situ fixation of the fragment RESULTS: Bony union was achieved in all cases after avg. 48 months (33~73 months) follow-up assessment. According to the score system of Dhillon et al, 7 patients had excellent, 3 had good, 2 had fair results. None of the patients developed avascular necrosis or premature closure of the epiphysis. CONCLUSION: We suggest that in situ fixation is an effective method for the late treatment of slightly displaced fracture of the lateral humeral condyle.

Surgical Treatment for the Neglected Non-union of the Lateral Humeral Condyle / 대한정형외과학회잡지

PURPOSE: To assess the clinical results of surgical treatment for established nonunion of the lateral humeral condyle and to determine the factors necessary for successful outcome. MATERIALS AND METHODS: 12 patients with nonunion of the lateral humeral condyle underwent open reduction, autogenous iliac bone graft and internal fixation with two smooth or treated K-wires between 1994 and 1999. Mean age was 16 years and the mean follow-up period was 2 years and 8 months. RESULTS: All of the patients achieved solid union at the nonunion site and were free of pain in the elbow upon strenuous activities. Average union time was 7.2 weeks after the surgery. Aggressive anatomical reduction of the fragment must not be undertaken because it may disturb a well adapted joint congruity in adults. Rigid internal fixation with iliac bone graft and preservation of the blood supply of the distal fragment are important factors for a successful outcome. The range of motion of the elbow joint decreased 10.5 degrees on average after surgery. Valgus deformity improved in four of six patients. CONCLUSION: The patients with symptomatic established nonunion are good candidates for surgery, even adults.

Change of Carrying Angle in Fracture of the Lateral Humeral Condyle in Children / 대한정형외과학회잡지

From June 1980 to May 1986, 24 fractures of the lateral condyle of humerus in children ranging in age from 1 to 11 years were treated at the Department of Orthopedic Surgery, Kyungpook National University Hospital. Authors have been analized all cases of fractures clinically, especially the change of carryin angle by radiographic examination in follow-up periods. The results were as follows : 1. Fractures are more common in male than female. Mean age at time of fracture was 5.4 years. Fractures were predominated in the left side by 66.7%. 2. By the classification of epiphyseal injury, all cases were Salter-Harris type IV. By the classification of fragment displacement, Wadsworth type II fracture was most comrnon in 66.7%. They were treated with open reduction and internal fixation in 20 and with conservative treatment in 4. 3. The range of change in carrying angle was distributed from 9 degree decrease to 8 degree increase with a mean of 4.1 degrees. The range of change in carrying angle was influenced by degree of fragment displacement at the time of initial injury and longer period of follow-up. 4. The complications were lateral condylar voergrowth(20.8%), premature epiphyseal fusion(8.4%), snd nonunion(4.1%). By the criteria of Hardacre et al, 8 cases(33.3%) showed excellent result, 15 cases (6. 2%) showed good result, and 1 case (4.2%) showed poor result.