ObjectiveThe best approach between closed reduction and open reduction in the treatment of total displaced and rotated LCFs is still being debated. This study aimed to comparatively evaluate the clinical outcomes and complications of closed reduction vs. open reduction in the treatment of displaced and rotated lateral condyle fractures in children.MethodsWe retrospectively evaluated 46 children who underwent surgical treatment for totally displaced and rotated lateral condyle fractures. Thirty-one children underwent open reduction and percutaneous pinning (ORPP). Ten children underwent closed reduction and percutaneous pinning (CRPP). Five children were changed to ORPP procedures because of the failure of closed reduction attempts. Clinical outcomes and complications in the groups were compared.ResultsAmong three groups, no significant differences were found in demographic variables, and no differences were detected in the incidence of postoperative complications and clinical parameters. The ORPP group had the shortest surgical duration of the three groups (p < 0.005). Patients in CRPP group had faster fracture healing than the patients who underwent open reduction procedures. However, the success of CRPP seemed to be dependent on the earlier surgical intervention.ConclusionORPP is still the first-line treatment for the totally displaced and rotated lateral condyle fractures because of its direct visualization of the joint surface and easy-to-accomplish characteristics. In addition, CRPP may be a feasible option for the treatment of this type of fractures because of it is less invasive and potentially minimizes complications. However, the technical difficulties of CRPP must be taken into account.

Background: This study presents the clinical results from 22 children who underwent minimally invasive arthroscopically assisted screw fixation for the treatment of intercondylar eminence fractures.Methods: We retrospectively analyzed the clinical data of 22 children (aged 7.5 to 13.5 years) with type III tibial intercondylar eminence fractures who were treated in our department from March 2007 to September 2019. According to the type of operation, the patients were divided into two groups: group A (n = 12) received arthroscopically assisted cannulated screw fixation, and group B (n = 10) received open reduction and cannulated screw internal fixation. Radiography scans, Lysholm scores, International Knee Documentation Committee (IKDC) 2,000 subjective scores, Tegner scores, range of motion (ROM) of the knee, the anterior drawer test (ADT), the Lachman test, and the pivot-shift test were used to evaluate the clinical efficacy.Results: All 22 children were evaluated over a 12 to 58 month follow-up period (mean: 27.5 months). At the final exam, group A was significantly superior to group B in Lysholm scores (93.33 ± 3.55 vs. 86.20 ± 4.52), IKDC scores (92.06 ± 3.55 vs. 86.07 ± 5.81), and Tegner scores (7.75 ± 0.87 vs. 6.40 ± 0.52) and presented shorter operative times (25.42 ± 3.97 vs. 35.00 ± 5.27). The differences were statistically significant (P < 0.05). All the incisions healed primarily. No complications, such as fracture fragment displacement, delayed epiphyseal growth, or knee joint dysfunction, were observed. The drawer test, Lachman test, and pivot-shift test were negative for all patients.Conclusions: Arthroscopically assisted cannulated screw fixation is effective and safe for the treatment of tibial intercondylar eminence fractures, providing excellent stability and quick recovery of joint function.

Background The purpose of this study was to evaluate the efficacy of closed reduction (CR) in the treatment of developmental dysplasia of the hip (DDH) and to investigate risk factors associated with CR failure and avascular necrosis (AVN) occurrence in follow-ups. Methods The study retrospectively included 110 patients and 138 hips with DDH diagnosis that underwent closed reduction between February 2012 and November 2015 in our single tertiary medical institution. The failure rate of CR and the underlying risk factors were evaluated. Meanwhile, the incidence of AVN and the related risk factors among the successful CR cases were assessed. Results The overall failure rate of DDH treated by CR in the present study was 31.16% (43/138). Risk factors for the CR failure were older age at the time of CR (≥ 18.35 month), large medical interval before CR (≥ 35.35 mm), and severer dislocation of the affected hip (IDHI grades III and IV). The incidence of AVN was 8.33% (6/72) in patients with successful CR at the last follow-up. No significant risk factors had been established in the present study that associated with the AVN occurrence. Conclusions For the treatment of DDH with CR, patients with younger age might achieve better outcomes; early diagnosis and early treatment might be the key point in the DDH treatment.