Shaft-Condylar Angle for surgical correction in neglected and displaced lateral humeral condyle fracture in children

Acta Orthop Belg. 2015 Sep;81(3):384-91.

Abstract

Purpose: To assess the outcome after using the Shaft-Condylar angle (SCA) as intraoperative reference for sagittal plane correction in displaced lateral humeral condyle fractures in children presented 3-weeks after injury.

Methods: Ten children, with delayed presentation of a displaced lateral humeral condyle fracture and undergoing surgery during 1999-2011, were reviewed. The goal was to obtain a smooth articular surface with an intraoperative SCA of nearly 40° and nearest-anatomical carrying angle. They were allocated into two groups according to the postoperative SCA [Good-reduction group (SCA=30-50°), and Bad-reduction group (SCA<30°, >50°)] and the final outcomes were then compared.

Results: All fractures united without avascular necrosis. The Good-reduction group (n=7) showed a significant improvement in final range of motion and functional outcome compared to the Bad-reduction group (n=3) (p=0.02). However, there was no significant difference in pain, carrying angle and overall outcome between both groups.

Conclusion: SCA is a possible intraoperative reference for sagittal alignment correction in late presented displaced lateral humeral condyle fractures.

MeSH terms

  • Child
  • Child, Preschool
  • Elbow Joint / diagnostic imaging
  • Elbow Joint / physiopathology
  • Elbow Joint / surgery*
  • Epiphyses / injuries*
  • Female
  • Follow-Up Studies
  • Fracture Fixation, Internal / methods*
  • Fractures, Malunited / diagnostic imaging
  • Fractures, Malunited / physiopathology
  • Fractures, Malunited / surgery*
  • Humans
  • Humeral Fractures / diagnostic imaging
  • Humeral Fractures / surgery
  • Infant
  • Male
  • Osteotomy / methods*
  • Radiography
  • Retrospective Studies