Radiological comparison of parallel fixation and divergent fixation using K-wire in pediatric lateral condyle fractures

Abstract

Aim: Lateral condyle fractures (LCF) of the humerus are the second most common (10-20%) after supracondylar fractures in childhood. Many methods have been described in the literature for their treatment, but a gold standard method has not been proposed. In this study, we aimed to compare the radiological results and complications of 2 different fixation methods (parallel or divergent) with K-wire in treatment. Methods: Patients under 18 years of age who were operated in our hospital due to humeral LCF between January 2014 and January 2020 were included in this retrospective cohort study. They were divided into Group 1 (fixed with parallel K-wire) and Group 2 (fixed with divergent K-wire). The age, and gender of the patients were noted, and side, type of fracture, type of treatment, radiological union times, nonunion or delayed union, fishtail deformity, excessive growth of the lateral condyle (spur) and avascular necrosis were evaluated using plain radiographs. Results: The mean age of 41 patients included in the study were 4.69 years, there were 28 males and 13 females. The most common type of fracture was Weiss type 2 (n=23). The most common complication was lateral overgrowth (spur) (n=7). There was no significant difference between the radiological union times and the number of complications in both groups (P=0.079, P=0.56 respectively). Conclusion: Both methods used in LCF fractures yielded satisfactory results. Avascular necrosis rates are high in the treatment of type 3 fractures, in which strict follow-up is important.