Cannulated Screw Versus Kirschner Wire Fixation Following Open Reduction of Lateral Condyle Fracture of Humerus

Abstract

Background: Lateral condyle fracture (LCF) of the immature humerus is a transphyseal intra-articular injury. Where there is more than two millimeters of displacement, open reduction and internal fixation (ORIF) with anatomic reduction and secure fixation are essential to avoid complications. The aim of this study is to analyze the outcome of cannulated screw versus two divergent Kirschner wire (K-wire) fixation following open reduction of displaced lateral condyle fracture of humerus. Methods: A prospective randomized controlled trial was performed including 64 children in 2 treatment groups: Group-A (screw fixation) and Group-B (Kirschner wires). Primary outcome measures were radiological outcome and functional outcome. Secondary outcomes were stability of fixation and post-operative complications. Results: There was no significant difference in demographic characteristics of the children between two groups. Screw fixation was significantly superior in radiological outcome than K-wires. There was no significant difference in functional outcome or the stability of fixation between the two groups. Surgical site infection and lateral condylar overgrowth were significantly higher in the K-wire fixation group. Conclusion: Cannulated screw fixation is superior in radiological outcome with fewer complications than K-wire fixation in displaced LCF of humerus in children. But there was no significant difference in functional outcome and stability of fixation. Keywords: Cannulated screw, Kirschner wire, Lateral condyle fracture of Humerus, Children