Abstract
OBJECTIVE: To evaluate the efficacy of closed reduction percutaneous pinning (CRPP) in the treatment of Song V lateral humeral condyle fractures in children. METHODS: Medical records of pediatric patients who underwent surgical treatment for lateral humeral condyle fractures at our institution from July 2018 to August 2024 were retrospectively reviewed. Inclusion criteria: (1). Age ≤14 years; (2). Time from injury to surgery ≤3 days; (3). Song V lateral humeral condyle fracture. Exclusion criteria: (1). Open fracture or concomitant fractures; (2). Associated neurovascular injury; (3). Pathological fracture or concomitant metabolic diseases; (4). Incomplete clinical or radiological data; (5). History of previous surgery on the ipsilateral elbow. Patients meeting the criteria were divided into two groups based on surgical approach: open reduction (n = 43) and closed reduction (n = 46). Gender, age, affected side, intraoperative blood loss, and operative duration were recorded. Elbow function was assessed using the Mayo Elbow Performance Score (MEPS) at the one-year postoperative follow-up. Overgrowth of the lateral condyle was evaluated on anteroposterior radiographs by the presence of a prominent lateral spur; overgrowth was defined as a final interepicondylar width (IEW)/initial IEW ratio >1.1. RESULTS: The mean age in the closed reduction group was 4.87 ± 1.55 years, compared to 4.53 ± 1.57 years in the open reduction group, showing no statistically significant difference (t = 1.0126, P = 0.314). There were also no significant differences between the two groups in terms of gender distribution (χ² = 2.715, P = 0.099) or affected side (left/right) (χ² = 0.01, P = 0.914). The closed reduction group demonstrated significantly less intraoperative blood loss (1.02 ± 0.15 mL vs. 3.77 ± 3.22 mL; U = 240.5, P < 0.001) and shorter operative duration (52.96 ± 19.52 min vs. 91.84 ± 30.16 min; U = 275.0, P < 0.001). At the one-year follow-up, no significant difference was found in MEPS (99.78 ± 1.02 vs. 99.53 ± 1.45; U = 841.0, P = 0.180). Evaluation of lateral condyle overgrowth also showed no significant difference between the groups (χ (2) = 2.46, P = 0.12). CONCLUSION: Closed reduction percutaneous pinning fixation for Song V lateral humeral condyle fractures achieves surgical outcomes comparable to open reduction. However, CRPP offers the advantages of minimal scarring and significantly shorter operative time.