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Topic:

Lateral Humeral Condyle Fracture

Issue:

Elbow

Category:

Trauma

Title:

Closed Reduction Techniques Are Associated With Fewer Complications Than Open Reductions in Treating Moderately Displaced Pediatric Lateral Humeral Condyle Fractures: A Multicenter Study

Author:

Tippabhatla, Abhishek BS; Torres-Izquierdo, Beltran MD; Pereira, Daniel E. MD; Goldstein, Rachel MD, MPH; Sanders, Julia MD; Bellaire, Laura MD; Neal, Kevin MD; Denning, Jaime MD; Hosseinzadeh, Pooya MD

Journal:

Journal of Pediatric Orthopaedics

Date:

November/December 2024

Reference:

44(10): p e865-e870, DOI: 10.1097/BPO.0000000000002777

Level Of Evidence:

III

# of Patients:

480 fractures (202 treated with closed reduction, 278 with open reduction)

Study Type:

Retrospective, multicenter study

Location:

6 academic level 1 trauma centers, data collected from 2005-2019

Summary:

This study compares the outcomes of closed vs. open reduction in treating moderately displaced pediatric lateral humeral condyle fractures. It shows that closed reduction is associated with fewer complications like delayed healing and elbow stiffness compared to open reduction.

Methods:

Retrospective data from patients aged 1 to 12 years, treated for lateral condyle fractures at 6 academic level 1 trauma centers. Data collected on patient demographics, radiographic parameters, reduction type, hardware fixation, and complications.

Exclusions:

Fractures classified as Song 5

Results:

After propensity score matching, delayed healing and stiffness were significantly higher in the open reduction group (52% vs. 28% for delayed healing, 22% vs. 10% for stiffness). No significant differences in infection or nonunion rates.

Conclusions:

Closed reduction is recommended as the first-line treatment for moderately displaced lateral humeral condyle fractures due to better outcomes (less stiffness and delayed healing).

Relevance:

Limitations:

Perspective:

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