OUTCOME OF OPERATIVE MANAGEMENT OF NEGLECTED LATERAL CONDYLAR FRACTURE IN CHILDREN

Abstract

BACKGROUND: Fracture lateral Condyle of Humerus is the 2nd commonest fracture in children
around the Elbow joint. It is called the Fracture of necessisity. It is famous for its complications like
N/U, M/U & growth arrest with elbow Deformity. These are Intra articular fractures caused by fall with
varus force on the elbow. It is most common at the age of 6-7 years. Its management is controversial
especially in late, neglected cases.
OBJECTIVE: To determine the outcomes of open reduction and internal fixation of lateral condylar
fractures of humerus in children presented between 3 and 9 weeks.
MATERIALS AND METHODS: It was descriptive case study of 27 patients presented with more than
3 weeks of fracture and displacement of more than 2 mm from September 2013 to March 2015 admitted
through OPD at Orthopedics Unit of Saidu Teaching Hospital Swat, Department of Orthopedics, Khyber
Teaching Hospital Peshawar and Department of Orthopedics and Spine Surgery Ghurki Trust Teaching
Hospital Lahore. Detailed history, clinical examination and investigations were done after proper
consent. Pre operative diagnosis was made on antero posterior and lateral views of plan x rays. Fractures
were managed with open reduction and internal fixation and were followed regularly on OPD basis and
outcome was documented using Hardacre criteria. The results were analyzed using SPSS 17.0.
RESULTS: There were 27 patients with mean age of 7±2.7years.66.7% were male and 33.3 % were
female .55.6% of patients involved non dominant hand while remaining dominant hand.14 patients
were initially managed by bone setters,7 managed by parents as home remedies,2 missed by physician
and 4 displaced in cast.77.78% of patients presented between 3-5 weeks shows excellent result, between
5-7 weeks 33.33% shows good results,55.56% shows excellent and 11.11% shows poor results ,between
7-9 weeks ,11.11% shows excellent, 44.44% shows good and poor results..
CONCLUSION: Open reduction and internal fixation is good option for patients presented after 3
weeks having excellent results up to 7 weeks .Moreover it can be done even after weeks, but the rate of
complications increases as time passes more.
KEY WORDS: Lateral condylar fracture, children, Open reduction and internal fixation.