A Comprehensive Analysis of Complications in Pediatric Lateral Humeral Condyle Fractures

儿童肱骨外髁骨折并发症的综合分析

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Abstract

BACKGROUND: Complications such as subsequent displacement and non-union in children with non-displaced or minimally displaced lateral humeral condyle fractures (LHCF) may happen. We aim to identify potential prognostic factors that could influence the outcomes of these fractures. MATERIAL AND METHODS: A retrospective study in a level I trauma center was performed. The patient data included demographics, injured side, fracture displacement, treatment, and the occurrence of subsequent displacement, non-union, or other complications. Fractures were classified according to the Jakob's classification, relying on simple radiographs, and displacement was quantified in millimeters using anteroposterior (AP) and lateral views. RESULTS: The study sample comprised 89 children (80% Jakob I and 20% Jakob II). The mean age at the time of injury was 6 (3). Treatment was non-surgical in 81% of cases, while 19% received surgery. 24 patients (27%) experienced complications. Correlational analyses revealed that a higher degree of initial displacement showed significant associations with non-union, lateral condyle hypertrophy, and alignment disturbance. Predictive performance analysis indicated that displacement exceeding 1.5 mm should be surgically treated. CONCLUSIONS: Following non-displaced or minimally displaced LHCF, our study revealed an 8% occurrence of subsequent displacement and a 2% rate of non-union. An association between the initial degree of fracture displacement and the occurrence of non-union, lateral condyle hypertrophy, and alignment disturbances was observed. Fractures exhibiting displacement greater than 1.5 mm might be deemed appropriate for surgical intervention. LEVEL OF EVIDENCE: IV.

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