Abstract
OBJECTIVE: This study seeks to assess the clinical outcomes associated with closed reduction with percutaneous pinning (CRPP) in comparison to open reduction and internal fixation (ORIF) for AO/OTA Type C2 distal humeral intercondylar fractures in pediatric and adolescent populations. A systematic review of the literature was performed to identify strategies that facilitate rapid recovery of elbow function and prevent complications. METHODS: A retrospective analysis was conducted on 36 cases that were treated and followed up from November 2015 to September 2023. In addition, a systematic review of the literature was performed, covering the period from 1958 to 2025. Providing aggregated data on 62 pediatric patients. Radiological parameters, including the Baumann angle, lateral humeral condylar angle, and horizontal rotation rate, were measured using AutoCAD software. Postoperative functional outcomes were evaluated using the Visual Analog Scale (VAS), elbow range of motion, and the Mayo Elbow Performance Score (MEPS). Complications such as heterotopic ossification and trochlear necrosis were also monitored. RESULTS: The mean follow-up duration was 24.71 ± 20.19 months, with all cases achieving clinical union within 6-8 weeks post-surgery. The CRPP group exhibited a significantly shorter operative time (34.28 ± 8.74 min vs. 54.67 ± 10.96 min) and reduced fluoroscopic exposure (24 ± 9 vs. 11 ± 3 instances) compared to the ORIF group (both P < 0.05). Radiological parameters, including the Baumann angle, lateral humeral condylar angle, and horizontal rotation rate, did not show statistically significant differences at 16 weeks post-surgery or at the final follow-up (P > 0.05). At the final follow-up, the CRPP group achieved significantly greater elbow flexion (139.72 ± 2.45° vs. 136.92 ± 3.06°) compared to the ORIF group (P < 0.05), while extension outcomes were comparable (P > 0.05). No significant differences were observed in VAS scores, MEPS scores, or complication rates between the two groups (P > 0.05). CONCLUSION: CRPP demonstrates non-inferiority to ORIF in achieving functional recovery, with advantages in operative efficiency for select cases. CLINICAL TRIAL REGISTRATION: http://www.medresman.org.cn/uc/projectsh/projectadd.aspx, Identifier ChiCTR2500113475.