Dp. Thomas et al., Three weeks of Kirschner wire fixation for displaced lateral condylar fractures of the humerus in children, J PED ORTH, 21(5), 2001, pp. 565-569
The authors assessed whether a period of 3 weeks, rather than the commonly
used 6 weeks, of smooth Kirschner wire fixation and cast immobilization of
the elbow was sufficient to achieve union of displaced fractures of the lat
eral humeral condyle treated by open reduction. The authors found only one
nonunion in a case series of 104 children treated with 3 weeks of fixation.
Infections occurred in two children (2%). Late review of 63 children (61%)
showed abnormalities of elbow shape in 28 (44%) and wide surgical scars in
43 (68%). The abnormalities of elbow shape were mainly due to over-growth
of the lateral humeral condyle, to the formation of excessive amounts of bo
ne over the outer surface of the condyle, or both. The authors' findings in
dicate that a period of 3 weeks of smooth Kirschner wire fixation and elbow
immobilization is sufficient to achieve healing in most displaced fracture
s of the lateral humeral condyle treated by open reduction, The findings al
so indicate that new strategies are needed to reduce the occurrence of over
growth of the lateral condyle, excessive formation of bone over the condyle
, and wide scars.