Biodegradable pins for lateral condylar fracture of the humerus with an early delayed presentation in children: a retrospective study of biodegradable pin vs. Kirschner wire

Abstract

Background The clinical outcome of open reduction and internal fixation (ORIF) for delayed lateral condylar fracture of the humerus (LCFH) varies in different studies, but ORIF for LCFH with an early-delayed presentation usually resulted in significant improvement of elbow function. Early delayed presentation is defined as a period of 3 to 12 weeks from the injury. This study aims to compare the clinical outcomes of biodegradable pin (BP) vs. Kirschner wire (KW) in the treatment of LCFH with an early delayed presentation. Methods LCFH with an early-delayed presentation treated with KW or BP were retrospectively reviewed in our hospital. The patients were divided into two groups KW (n = 17) and BP group (n = 26). Baseline information, including sex, age, operative side, duration from injury to surgery, and implant choice, was reviewed. Radiographs and medical records were collected from the Hospital Database. Results In all, 17 patients (male/female, 9/8) in KW and 26 patients (male/female,13/13) in the BP group were included. The age showed no statistically significant difference between the KW (52.3 ± 10.2, month) and the BP (56.1 ± 10.7, month), (P = 0.258). At the last follow-up, there existed no statistically significant difference between the two groups concerning Baumann’s angle (P = 0.272) and carrying angle (P = 0.911). The MEPS at the last follow-up was better in the KW group (91.1 ± 2.7) than the BP group (89.2 ± 3.0), (P = 0.048). There was no case of nonunion or malunion in both groups. The incidence of fishtail deformity was (8/17, 47.1%) in KW and (13/26, 50%) in the BP group. The incidence of lateral prominence was (5/17, 29.4%) in the KW and (7/26, 26.9%) in the BP group. Furthermore, the incidence of implant prominence was higher in KW (12/17, 70.6%) than BP (0) (P < 0.001). Conclusion Open reduction and internal fixation for LCFH with an early-delayed presentation produced satisfactory outcomes. Biodegradable pin is a good alternative to Kirschner wire, with comparable clinical outcomes.

Early versus delayed treatment of lateral condylar fracture of the humerus with > 2 mm displacement in children: a retrospective study

“…On the other hand, satisfactory outcomes have been reported in other studies [15][16][17], especially in patients with an early-delayed presentation. Li et al [10] retrospectively studied 43 lateral LCFH where 17 of their patients were treated with K-wires and 26 patients were treated with biodegradable pins. The authors hypothesized that open reduction and internal fixation for LCFH with an early-delayed presentation produced satisfactory outcomes.…”

“…The effect of early versus delayed treatment has been a topic of interest for various fracture types [6][7][8][9]. It is possible that early operative treatment for LCFH may prevent complications such as infection, malunion and nonunion [10]. However, few studies in the literature comparing early and delayed surgery for displaced fractures of the lateral condyle of the humerus have been reported.…”

Change in Pull-Out Force during Resorption of Magnesium Compression Screws for Osteosynthesis of Mandibular Condylar Fractures

“…For this reason, in recent years, this class of resorbable fixation materials has aroused considerable interest in maxillofacial surgery [ 40 , 46 ]. Other advantages include anti-inflammatory [ 47 , 48 ] and antibacterial activity [ 49 , 50 , 51 ] as well as bone formation induction [ 52 , 53 ]. However, primacy leads to the fact that this fixation material will not have to be removed from the body through a second surgical procedure.…”

Application of ultrasound in the management of TRASH (the radiographic appearance seemed harmless) fractures in preschool children: A review

“…The nature of preschool children with unossified secondary ossification center is seen to be normal-like on the X-ray images, and the large cartilaginous "empty spaces" may harbor harmful injuries, which could cause serious consequences or deformities. [1][2][3] In 2010, Waters et al identified 8 fractures with Radiographic Appearance Seemed Harmless (TRASH) fracture of the elbow, recommending that surgeons should be more careful to do physical examination. [4] The ultrasound or magnetic resonance imaging were also advised to confirm diagnoses.…”

“…The nature of preschool children with unossified secondary ossification center is seen to be normal-like on the X-ray images, and the large cartilaginous “empty spaces” may harbor harmful injuries, which could cause serious consequences or deformities. [ 1 – 3 ]…”