Open reduction of pediatric lateral condyle fractures: a systematic review

Shoulder Elbow. 2022 Jun;14(3):317-325. doi: 10.1177/17585732211010299. Epub 2021 Apr 22.


Introduction: Lateral condyle fractures are the second most common pediatric elbow fracture. There exist multiple options for internal fixation including buried K-wires, unburied K-wires, and screw fixation. Our study aims to review the current literature and determine if fixation strategy affects outcomes to include fracture union, postoperative range of motion, and need subsequent surgery.

Methods: A systematic review of Pubmed, MEDLINE, and EMBASE databases was performed. Included articles involve pediatric patients with displaced lateral condyle fractures treated with internal fixation that reported outcomes to include union rates and complications.

Results: Thirteen studies met inclusion criteria for a total of 1299 patients (472 buried K-wires, 717 unburied K-wires, and 110 screws). The patients' average age was 5.8 ± 0.6 years, male (64%), and had 16.3 months of follow-up. No differences in union and infection rates were found. Unburied K-wires had the shortest time to union and the greatest elbow range of motion postoperatively.

Conclusions: Our systematic review demonstrates similar outcomes with union and infection rates between all fixation techniques. Unburied K-wires demonstrated a shorter time to union and the greatest postoperative range of motion. Additionally, unburied K-wires may be removed in clinic, decreasing the cost on the healthcare system.

Evidence: Level 3.

Keywords: K-wire fixation; Pediatrics; elbow fracture; lateral condyle; open reduction; orthopedics; pediatric orthopedics; screw.