Clinical and Radiological Results of Open Reduction and Internal Fixation for the Treatment of Lately Presented Lateral Humeral Condyle Fractures in Children

While there is consensus about the treatment of acutely presented displaced lateral condyle fracture (LCF) of distal humerus in children by open reduction and internal fixation, treatment for lately presented LCF remained challenging due to contradictory results of treatments and paucity of studies in this field.
The aim of this study was to report the clinical and radiological results of open reduction and internal fixation for the treatment of lately presented LCF of distal humerus in children.
Prospectively we studied the clinical and radiographical results of open reduction and internal fixation of 8 patients from 12 cases. These cases had a delayed presentation of more than 3 weeks from injury among those who were referred to our center from 2011 to 2017. We evaluated the range of motion, alterations in carrying angle, presence of prominent deformity, presence of arthritic or neurological symptoms, and finally nonunion or avascular necrosis of the lateral condyle. For assessment of the treatment results we used the Hardacre criteria.
A total of 8 patients, including 7 males and 1 female with mean age of 5.2 years (2.5 - 8) bearing time delay from injury to the surgery of 32.4 days (22 - 48), underwent surgical treatment. The mean follow up was 21 months (8 - 54). The main reason for referring to the clinic consisted of palpable mass followed by decreased range of motion. All patients achieved satisfactory union. Of the patients, 2 suffered from complications; 1 patient experienced avascular necrosis of the lateral condyle and the other was complicated by carrying angle abnormality. According to the Hardacre criteria, 6 patients achieved excellent results and 2 patients, with mentioned major complications, obtained fair results.
Open reduction and internal fixation of lately presented lateral condyle fracture of distal humerus can result in excellent functional and radiological results in most of the patients.