Fixation of Lateral Condyle Humerus Fractures in Children by Terminally Threaded Screws

Abstract

Background: Concerns regarding fixation loss with short-term use of K-wires led to the emergence that screws fixation for lateral condyle fractures provides more stable fixation. This study aimed to evaluate the results of fixation in cases who presented with lateral humeral fractures using terminally threaded screws.Methods: This randomized prospective interventional clinical study consisted of 30 Children (2-14) years old who attended the orthopedic surgery department at Zagazig University Hospital with lateral condyle humerus fractures in 6 months. According to the Song classification-based treatment stages, the fracture displacements were staged: Stage 1&2: Treated conservatively by a posterior slap or cast for 4-6 weeks. Stages 3 & 4: managed surgically through closed reduction and fixation. Stage 5: managed surgically through open reduction and fixation.Results: The union mean time was 8 weeks, ranging from 3.9 to 10 weeks. Two months after surgery, the screw fixation was no longer stable for one patient, and reduction was lost. The range of extension ranged from 5 to 15 degrees. Of the 30 patients surveyed, 27 had an extension range of reach below 15 degrees, whereas only three had a reach extension of more than 15 degrees.Conclusion: Children's lateral condyle humerus fractures can be safely and effectively fixed with terminally threaded screws, which have been shown to increase the likelihood of a successful closed reduction, reduce the risk of infection and iatrogenic vascular necrosis, and provide enough stability to facilitate early rehabilitation in addition to easy mobilization