Abstract

Introduction: Lateral condyle fracture of humerus in children is the most common elbow fracture that involves the growth plate and the second most common elbow fracture children following supracondylar fracture of thehumerus. The purpose of the study was to evaluate the clinical outcome of operative treatment of displaced lateral condyle fractures using cannulated cancellous screws.

Method: We reviewed 37 lateral condyle fracture of humerus in children treated with screw fixation, from July 2014 to June 2016. Patient with age 5 to 12 years, closed fracture with displacement >2mm, fracture with enough metaphysical fragment for screw and fracture <2weeks were included. Patients with open fractures, anatomical elbow deformity, associated another injury in thesame joint were excluded. Preoperative X-rays were used to classify fracture according to Milch classification Postoperative X-rays were used to evaluate screw positions, fracture union, thepresence of growthplate arrest and avascular necrosis.

Results: There were 26 boys and 6 girls in the study, with an average age of 7.7 (peak age mode 7, range 5 to 12 years). Average follow-up was 14months (range 8 to 24 months). The commonest mode of injury was fall from height (mainly tree) and it was seen in 24 patients (75%), and 8 patients (25%) had fractures caused by motor vehicle accidents. The final outcome was evaluated with Mayo Elbow Performance score. At final follow up 90.62% (n=29) had excellent outcome and 9% (n=3) had good outcome. There were no poor results.

Conclusion: Screw provides absolute stability which reduces the possibility of lateral prominence and promotes early fracture union. Absolute stability of fracture permits anearly range of motion with early return to pre-injury state.

Keywords: Lateral condyle; Fracture; Screw fixation