Radiological comparison of parallel fixation and divergent fixation using K-wire in pediatric lateral condyle fractures

Abstract

Aim: Lateral condyle fractures (LCF) of the humerus are the second most common (10-20%) after supracondylar fractures in childhood. Many methods have been described in the literature for their treatment, but a gold standard method has not been proposed. In this study, we aimed to compare the radiological results and complications of 2 different fixation methods (parallel or divergent) with K-wire in treatment. Methods: Patients under 18 years of age who were operated in our hospital due to humeral LCF between January 2014 and January 2020 were included in this retrospective cohort study. They were divided into Group 1 (fixed with parallel K-wire) and Group 2 (fixed with divergent K-wire). The age, and gender of the patients were noted, and side, type of fracture, type of treatment, radiological union times, nonunion or delayed union, fishtail deformity, excessive growth of the lateral condyle (spur) and avascular necrosis were evaluated using plain radiographs. Results: The mean age of 41 patients included in the study were 4.69 years, there were 28 males and 13 females. The most common type of fracture was Weiss type 2 (n=23). The most common complication was lateral overgrowth (spur) (n=7). There was no significant difference between the radiological union times and the number of complications in both groups (P=0.079, P=0.56 respectively). Conclusion: Both methods used in LCF fractures yielded satisfactory results. Avascular necrosis rates are high in the treatment of type 3 fractures, in which strict follow-up is important.

Keywords

• lateral condyle
• fracture
• humerus
• lateral spur
• child

Pediatrik humerus lateral kondil kırıklarında K-teli kullanılarak yapılan paralel tespit ile divergan tespitin radyolojik karşılaştırması

Abstract

Amaç: Çocukluk çağında humerusun lateral kondil kırıkları (LKK), suprakondiler kırıklardan sonra en sık (%10-20) ikinci sıradadır. Literatürde bu kırıkların tedavisi için birçok yöntem tanımlanmıştır, ancak altın standart bir yöntem önerilmemiştir. Bu çalışmada, tedavide K-teli ile 2 farklı fiksasyon yönteminin (parallel veya diverjan) radyolojik sonuçlarını ve komplikasyonlarını karşılaştırmayı amaçladık Yöntemler: Ocak 2014-Ocak 2020 tarihleri arasında hastanemize humerus LKK nedeniyle başvuran ve 18 yaş altı olan çocuk hastalar bu retrospektif kohort çalışmaya dahil edildi. Çalışmaya dahil edilen hastalarımızın tamamı LKK nedeniyle ameliyat edilen 18 yaş altı çocuklardan oluştu. Hastalar Grup 1; paralel K-teli ile sabitlenmiş ve Grup 2; diverjan K-teli ile sabitlendi. Her iki grupta yaş, cinsiyet, taraf, kırık tipi, tedavi tipi, radyolojik kaynama süreleri, kaynamama veya gecikmiş kaynama, fishtail deformitesi, lateral kondilde aşırı büyüme ve avasküler nekroz olan hastalar direk radyografiler kullanılarak değerlendirildi. Bulgular: Çalışmaya dahil edilen 41 hastanın yaş ortalaması 4,69 yıl, 28'i erkek, 13'ü kadındı. En sık görülen kırık tipi Weiss tip 2 idi (23 hasta). En sık görülen komplikasyon 7 hastada lateral aşırı büyümeydi. Her iki grupta da radyolojik kaynama süreleri ile komplikasyon sayısı arasında istatistiksel olarak anlamlı bir fark yoktu (sırasıyla P=0,079, P=0,56). Sonuç: LKK kırıklarında uygulanan 2 farklı yöntemin her ikisi de tatmin edicidir. Tip 3 kırıkların tedavisinde avasküler nekroz oranları yüksektir ve bu kırıklar da sıkı takip önemlidir.

Keywords

• Lateral kondil
• Kırık
• Humerus
• Lateral spur
• Çocuk

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