OUTCOME OF OPEN REDUCTION AND INTERNAL FIXATION OF DISPLACED MEDIAL EPICONDYLE HUMERUS FRACTURES IN CHILDREN

Abstract

BACKGROUND: Medical epicondyle fracture is one of the commonest elbow fracture in children.
Various treatment options exist inadequate treatment leads to elbow deformity. Our study will highlight
one treatment option with open reduction and fixation with k-wires or one screw and one k-wire.
OBJECTIVE: To determine the functional outcome of open reduction and internal fixation of
displaced medial epicondyle humerus fractures in children.
MATERIAL AND METHODS: This Descriptive cross sectional study was conducted simultaneously
at five orthopaedic units: Orthopaedic Unit District Headquarter Hospital Timergara Lower Dir,
Orthopaedic Unit, Saidu Teaching Hospital Swat, Department of Orthopaedics and Trauma Khalifa Gul
Nawaz Teaching Hospital Bannu, Orthopaedics and Traumatology Unit “ A†Lady Reading Hospital
Peshawar and Department of Orthopaedics and Trauma, Pak International Medical College Peshawar
from January 2012 to September 2014. Twenty one children meeting the inclusion criteria were operated
under general anaesthesia and tourniquet control and fracture was stabilized with either two kirschner
wires or a screw and single kirschner wire. All patients were discharged on first or second postoperative
day and advised active movements of fingers. Patients were called for follow up visit after two, six and
twelve weeks and elbow functions and deformity was evaluated in each visit using modified criteria of
Hardacre et al (25).
RESULTS: Twenty one patients including 14 males and 7 females with mean age 12.3 years (range 6 to
15 years) had displaced fracture of medial epicondyle and were operated. Two of our patients were lost
in follow up and they were excluded from the final results. After evaluating our results according to
modified Hardacre et al criteria, five patients (26.32%) had excellent results, eleven (57.89%) patients
had good results and three (15.78%) patients had poor results.
CONCLUSION: Early surgical stabilization of displace medial epicondyle humerus fractures in
children results in excellent and good functional outcome in majority of patients.
KEY WORDS: Medial epicondyle humerus, Open reduction and internal fixation, Kirschner wire.