Early Versus Late Removal of Internally Fixated Kirschner’s Wires for Displaced Lateral Condyle Fracture of Humerus in Children
Hari Prasad Sapkota1, Poojan K Rokaya2, *, Mangal Rawal2, Dhan Bahadur Karki2, Deoman Limbu2
1 Department of Orthopedics, Mid-Western Regional Hospital, Surkhet, Nepal
2 Department of Orthopedics, Karnali Academy of Health Sciences, Jumla, Nepal
Lateral condyle fracture of the distal humerus is the second most common paediatric elbow fracture. Unstable, rotated and displaced (>2 mm) fractures are managed with open reduction and internal fixation with Kirschner’s wires or screws. Debate persists as for how long the Kirschner’s wires should be placed in situ after internal fixation. We aimed to compare the functional and radiological outcome after early versus late removal of internally fixated Kirschner’s wires for displaced lateral condyle fracture of distal humerus.
Children that underwent early (3-4 weeks) or late (5-7 weeks) removal of Kirschner’s wire after open reduction and internal fixation for displaced lateral condyle fracture of humerus were observed for a period of minimum 6 months. Time to radiological union, carrying angle, range of motion was assessed and compared between early and late group. Functional outcome was compared using the Dhillon scoring system.
We report the outcome of 40 cases (20 cases in each early and late group). Radiological union was achieved in all the cases of both group at 12 weeks follow up. The mean loss of carrying angle was statistically insignificant (p = 0.394) between the early and late group. There was no significant difference between the early and late group in relation to arc of motion at 12 weeks (p=0.724) and 6 months (p=0.638) follow up. Using the Dhillon scoring system, there was 100% excellent Dhillon score in early group, 80% excellent and 20% good Dhillon score in late group. Functional outcome was statistically insignificant between the two groups (p = 0.106)
Early removal of internally fixated K-wires for displaced lateral condyle fracture of humerus in children showed similar radiological and functional results to late removal.
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* Address correspondence to this author at the Department of Orthopedics, Karnali Academy of Health Sciences, Jumla, Nepal; Tel: +977 9849083461; E-mail: firstname.lastname@example.org