Short-term Effect Of Cannulated Screw With K-wires Used As Internal Fixation In Management Of Pediatric Neglected Humeral Lateral Condylar Fractures

Objective To discuss the short-term effect of cannulated screw with K-wiresused as internal fixation in management of pediatric neglected humeral lateralcondylar fractures.Methods Eleven patients with neglected humeral lateral condylar fracture wereoperatively treated in our department from October2009to December2012. Therwere9boys and2girls, aged from2yrs and1m to6yrs and4ms old (average,4yrsand5ms). The duration of initially trauma to surgery ranged from30to90dys(average,52dys). According to Milch classification, there were4cases of type and7cases of type ē. Elbow function was limited to varying degrees. All patients werefixated with one cannulated screw with two crossed K-wires and followed-uppostoperatively, fracture healing time and complications were observed, Dhillon scoreand Baumman angle were used to assess elbow function at one-year follow-up.Results All11patients were followed up from12to34ms (average,22.7ms).Fracture healing was achieved6to8wks postoperatively. At one-year follow up, bythe Dhillon score,10patients got9points and1patient got8points, presenting a100%good to excellent rate; the average pre-operation elbow range of motion was（90.5±27.3°）, improved to （120.1±11.8°） one year postoperatively, with asignificant difference. The average Baumman angle wa（s74.3±4.2°）（ranged from68°to80°）. No post-operative injection, delayed union, malunion, nonunion, cubitusvalgus or varus, capitellum necrosis or iatrogenic lesions to vessels and nervesoccurred.Conlusion Cannulated screw with K-wires internal fixation can lead tosatifactory reduction, stable internal fixation and excellent short-term functionaloutcomes and fewer complications.