Closed Reduction and Internal Fixation of Displaced Unstable Lateral Condylar Fractures of the Humerus in Children
- 송광순; 강철형; 민병우; 배기철; 조철현
- Alternative Author(s)
- Song, Kwang Soon; Kang, Chul Hyung; Min, Byung Woo; Bae, Ki Cheor; Cho, Chul Hyun
- Publication Year
- Background: Open reduction and internal fixation of a displaced unstable fracture of the lateral condyle of the humerus in
a child usually produces a good result. Only a few reports have focused on closed reduction and internal fixation of these
fractures. We prospectively studied closed reduction and internal fixation to determine its usefulness as the initial
treatment for displaced unstable fractures of the lateral condyle of the humerus.
Methods: We classified lateral condylar humeral fractures into five groups according to the degree of displacement and
the fracture pattern as determined on four radiographic views and created an algorithm for the treatment of these fractures
on the basis of this classification system. We prospectively treated sixty-three unstable fractures (in forty-two boys and
twenty-one girls) and assessed the quality of closed reduction.
Results: Thirteen of seventeen stage-3 fractures were reduced to £1mmof residual displacement. Thirty of forty stage-4
fractures and three of six stage-5 fractures were reduced to £2 mm of displacement. In ten of forty stage-4 fractures and
three of six stage-5 fractures, closed reduction to within 2 mm failed and open reduction and internal fixation was
performed. There were no major complications such as osteonecrosis of the trochlea or capitellum, nonunion, malunion,
or early physeal arrest.
Conclusions: Closed reduction and internal fixation is an effective treatment for unstable displaced lateral condylar
fractures of the humerus in many children. If fracture displacement after closed reduction exceeds 2 mm, open reduction
and internal fixation is recommended.
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