Lateral Condyle Fracture of the Humerus in the Pediatric Age Group: A 10-Year Tertiary Center Experience

儿童肱骨外侧髁骨折:一家三级医疗中心十年的经验

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Abstract

Objective Lateral humeral condyle fracture is a relatively common elbow injury among children, which often has a subtle presentation and a high risk of developing complications. This study aimed to discuss the epidemiology of such injury among children presenting to a tertiary hospital emergency room in Riyadh, Saudi Arabia. Other objectives included analyzing possible predictors and risk factors for developing complications in such patients, which will contribute to implementing preventive measures. Methodology This was a single-center, retrospective study conducted on data collected from patients presenting to the pediatric emergency department of a tertiary hospital in Riyadh, Saudi Arabia, from January 1, 2014, to July 2024. Patients under 18 years of age, with a minimum of six months of follow-up and complete data in our medical records, were included. A total of 77 patients were identified by convenience sampling; seven were excluded due to incomplete data or a follow-up period of less than six months. Where appropriate, statistical significance between variables was assessed using Fisher's exact test and Pearson's chi-square test. A P-value cutoff of 0.05 at a 95% confidence interval was used to determine statistical significance. Results This study reviewed 70 cases of lateral condyle fractures of the humerus. The mean age of the patients was 4.34 years, with 42 (60%) being under five years. The majority of patients (36, 51.4%) were male, and 42 (60%) sustained their injuries at home. Most patients (51, 72.78%) presented with types 2 and 3 displacements. Initial management for the majority of patients (52, 74.3%) was surgical. Of the entire sample, 40 (57%) patients had complications, with lateral condyle overgrowth being the most common, followed by cubitus varus and elbow stiffness. Females were found to present with significantly less displacement (P = 0.037). The degree of displacement was found to be a strong predictor of developing fracture nonunion (P = 0.0392) and lateral condyle overgrowth (P = 0.02). Conclusions Our study demonstrates that lateral condyle fractures are associated with a high rate of complications and that surgical intervention is often required for such injuries. A high index of suspicion and physician vigilance is essential, as this injury can be easily missed if it is not displaced. Prompt identification and management are crucial to reduce the risk of subsequent complications.

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