Background:
Delayed presentation of lateral condylar fractures of the humerus is relatively
common in the developing regions of the world. Fractures of lateral condyle of
humerus in pediatric age group, the most common being distal humerus epiphyseal
injury, are commonly associated with delayed presentation to terminal health
care providers. Materials and Methods: Twenty-one children having fracture of
lateral condyle of humerus with duration of trauma more than 3 weeks were
included in the prospective study. Among the 21 patients, 13 were male and 8
were female. Average time of presentation was after 3 weeks of injury. All
patients had Milch type II injury. The patients were treated by open reduction
and internal fixation using Kirschner wire. The outcome
assessment according to the scoring system proposed by Dhillon et al. was used. Result: Mean month
at operation is 81.5 months (range, 64-112 months); 8 Right/13 Left. Reason
for presentation: Pain, swelling in 12; Pain, decreased elbow motion in 7;
Restriction of the elbow flexion in 2. Time from injury to Operation with mean 6.34 weeks, 3 weeks-≤ 6 weeks in 13 Patients, and > 6 weeks in 8 patients; Previous treatment:
Plaster cast in 15 Patients, and No treatment in 6 Patients; Mean time of
Follow-up: 66 Months; Mean Age at last Follow-up was 11.6 (range, 8.4-15.0).
To tell result, 38.1% is in Excellent; 33.3% is in Good; 14.3% is in Fair; and 14.3% is in Poor. Comparison of accepted result from time of injury to operation
was 3-6 weeks better than over 6
weeks with PValuate 0.001387. There were AVN in 1 case, Nonunion in 2 cases. Conclusion: Osteosynthesis by Kirschner wire
without bone grafting could provide solid bony union and improve elbow
function. However, this technique could not prevent an angular deformity
completely. Corrective osteotomy should be considered in patients with valgus
or varus deformities.
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