To evaluate Clinico-radiological and functional outcome of “early mobilization” after stable internal fixation with k-wires in displaced fracture of lateral condyle humerus in children

Abstract

Background: Lateral condyle fractures are the second most common pediatric elbow fractures, after those of the supracondylar region. They account for approximately 16.9% of those occurring in the upper limb. Most of them need to be managed operatively by open reduction and internal fixation with Kirschner wires followed by Splintage in an above elbow slab for at least 4 to 6 weeks. The present study was conducted to evaluate the functional outcome of early mobilization after stable internal fixation with 3 Kirschner wires. Methods: A prospective study was conducted including 30 patients having displaced fracture of lateral condyle humerus in children over a period of one year. All the patients were followed up for a minimum of 6 months. Age incidence, sex distribution, mode of injury, side involved, fracture classification, complications and functional outcomes were noted. Results: There were 22 males and 8 females. Average age was 6.18 years. 22 of them were Jakob III and 8 were Jakob II. Early mobilization was started in all patients from first post operative day. All fractures united by 6 weeks at time of wire removal. At the final follow up Dhillon functional score was evaluated and was found to be excellent in 24 patients, good in 5, fair in one and there was no patient with poor outcome. Conclusion: Our results demonstrate that displaced fractures of lateral condyle humerus managed operatively by open reduction and stable fixation with 3 K-wires can be mobilized immediately after surgery without any risk of loss of reduction and with good final functional results.