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Erschienen in: International Orthopaedics 7/2017

08.04.2017 | Original Paper

Paediatric lateral humeral condylar fracture outcomes at twelve years follow-up as compared with age and sex matched paired controls

verfasst von: Juha-Jaakko Sinikumpu, Tytti Pokka, Sarita Victorzon, Eija-Leena Lindholm, Willy Serlo

Erschienen in: International Orthopaedics | Ausgabe 7/2017

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Abstract

Introduction

Lateral humeral condylar fractures are the second most common elbow fractures in children. We present the long-term clinical and radiographic results.

Material and methods

All children (<16 years) in the geographic catchment area with lateral condylar fracture were asked to participate and 32 (76.2%) patients enrolled. Clinical and functional results are compared with randomly selected but age and sex matched normal controls at 12.4 years (range 10.6 to 16.0).

Results

Unsatisfactory clinical outcomes were found in 40.6% of the fracture cases vs. 6.3% controls (P = 0.003), according to Flynn’s criteria. Flexion-extension range of motion was decreased >5° in 13 cases (40.6%) and in four controls (12.5%, P = 0.013). One in four (N = 8, 25%) of the cases showed cubitus varus >5° and 15.7% (N = 5) had cubitus valgus >5°, compared to one cubitus valgus (3.1%) in controls (P = 0.002).

Conclusion

The majority of the adolescent and young adult patients (59.4%) with a previous paediatric lateral humeral condylar fracture had recovered well and showed good or excellent overall outcomes according to Flynn’s criteria for elbow assessment after a mean of 12.4 years post-injury. Long-term sequelae was unchanged regardless of treatment.
Literatur
1.
Zurück zum Zitat Tejwani N, Phillips D, Goldstein RY (2011) Management of lateral humeral condylar fracture in children. J Am Acad Orthop Surg 19:350–358CrossRefPubMed Tejwani N, Phillips D, Goldstein RY (2011) Management of lateral humeral condylar fracture in children. J Am Acad Orthop Surg 19:350–358CrossRefPubMed
2.
Zurück zum Zitat Emery KH, Zingula SN, Anton CG, Salisbury SR, Tamai J (2015) Pediatric elbow fractures: a new angle on an old topic. Pediatr Radiol 1–6 Emery KH, Zingula SN, Anton CG, Salisbury SR, Tamai J (2015) Pediatric elbow fractures: a new angle on an old topic. Pediatr Radiol 1–6
3.
Zurück zum Zitat Landin LA (1983) Fracture patterns in children. Analysis of 8,682 fractures with special reference to incidence, etiology and secular changes in a swedish urban population 1950–1979. Acta Orthop Scand Suppl 202:1–109 Landin LA (1983) Fracture patterns in children. Analysis of 8,682 fractures with special reference to incidence, etiology and secular changes in a swedish urban population 1950–1979. Acta Orthop Scand Suppl 202:1–109
4.
Zurück zum Zitat Kim SS, Kim HJ, Kim HH, Seok SY, Jung SY (2015) The changes in patient pattern for pediatric supracondylar and lateral condylar humeral fractures. J Korean Orthop Assoc 50:132–136CrossRef Kim SS, Kim HJ, Kim HH, Seok SY, Jung SY (2015) The changes in patient pattern for pediatric supracondylar and lateral condylar humeral fractures. J Korean Orthop Assoc 50:132–136CrossRef
5.
Zurück zum Zitat Landin LA, Danielsson LG (1986) Elbow fractures in children: an epidemiological analysis of 589 cases. Acta Orthop 57:309–312CrossRef Landin LA, Danielsson LG (1986) Elbow fractures in children: an epidemiological analysis of 589 cases. Acta Orthop 57:309–312CrossRef
6.
Zurück zum Zitat Salonen A, Pajulo O, Lahdes-Vasama T, Välipakka J, Mattila V (2013) Increased incidence of distal humeral fractures and surgical treatment in 0-to 18-year-old patients treated in finland from 1987 to 2010. J Child Orthop 7:559–564CrossRefPubMedPubMedCentral Salonen A, Pajulo O, Lahdes-Vasama T, Välipakka J, Mattila V (2013) Increased incidence of distal humeral fractures and surgical treatment in 0-to 18-year-old patients treated in finland from 1987 to 2010. J Child Orthop 7:559–564CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Chen FS, Diaz VA, Loebenberg M, Rosen JE (2005) Shoulder and elbow injuries in the skeletally immature athlete. J Am Acad Orthop Surg 13:172–185CrossRefPubMed Chen FS, Diaz VA, Loebenberg M, Rosen JE (2005) Shoulder and elbow injuries in the skeletally immature athlete. J Am Acad Orthop Surg 13:172–185CrossRefPubMed
9.
Zurück zum Zitat Marcheix P, Vacquerie V, Longis B, Peyrou P, Fourcade L, Moulies D (2011) Distal humerus lateral condyle fracture in children: when is the conservative treatment a valid option? Orthop Traumatol Surg Res 97:304–307CrossRefPubMed Marcheix P, Vacquerie V, Longis B, Peyrou P, Fourcade L, Moulies D (2011) Distal humerus lateral condyle fracture in children: when is the conservative treatment a valid option? Orthop Traumatol Surg Res 97:304–307CrossRefPubMed
10.
Zurück zum Zitat Sullivan AJ (2006) Fractures of the lateral condyle of the humerus. J Am Acad Orthop Surg 14:58–62CrossRefPubMed Sullivan AJ (2006) Fractures of the lateral condyle of the humerus. J Am Acad Orthop Surg 14:58–62CrossRefPubMed
11.
Zurück zum Zitat Bhandari M, Tornetta P, Swiontkowksi MF (2003) Displaced lateral condyle fractures of the distal humerus. J Orthop Trauma 17:306–308CrossRefPubMed Bhandari M, Tornetta P, Swiontkowksi MF (2003) Displaced lateral condyle fractures of the distal humerus. J Orthop Trauma 17:306–308CrossRefPubMed
12.
Zurück zum Zitat Vallila N, Sommarhem A, Paavola M, Nietosvaara Y (2015) Pediatric distal humeral fractures and complications of treatment in finland: a review of compensation claims from 1990 through 2010. J Bone Joint Surg Am 97:494–499. doi:10.2106/JBJS.N.00758 CrossRefPubMed Vallila N, Sommarhem A, Paavola M, Nietosvaara Y (2015) Pediatric distal humeral fractures and complications of treatment in finland: a review of compensation claims from 1990 through 2010. J Bone Joint Surg Am 97:494–499. doi:10.​2106/​JBJS.​N.​00758 CrossRefPubMed
13.
Zurück zum Zitat Mizuta T, Benson W, Foster B, Morris L (1987) Statistical analysis of the incidence of physeal injuries. J Pediatr Orthop 7:518–523CrossRefPubMed Mizuta T, Benson W, Foster B, Morris L (1987) Statistical analysis of the incidence of physeal injuries. J Pediatr Orthop 7:518–523CrossRefPubMed
14.
15.
Zurück zum Zitat Launay F, Leet AI, Jacopin S, Jouve J, Bollini G, Sponseller PD (2004) Lateral humeral condyle fractures in children: a comparison of two approaches to treatment. J Pediatr Orthop 24:385–391CrossRefPubMed Launay F, Leet AI, Jacopin S, Jouve J, Bollini G, Sponseller PD (2004) Lateral humeral condyle fractures in children: a comparison of two approaches to treatment. J Pediatr Orthop 24:385–391CrossRefPubMed
16.
Zurück zum Zitat So Y, Fang D, Orth MC, Leong J, Bong S (1985) Varus deformity following lateral humeral condylar fractures in children. J Pediatr Orthop 5:569–572CrossRefPubMed So Y, Fang D, Orth MC, Leong J, Bong S (1985) Varus deformity following lateral humeral condylar fractures in children. J Pediatr Orthop 5:569–572CrossRefPubMed
17.
Zurück zum Zitat Skak SV, Olsen SD, Smaabrekke A (2001) Deformity after fracture of the lateral humeral condyle in children. J Pediatr Orthop B 10:142–152PubMed Skak SV, Olsen SD, Smaabrekke A (2001) Deformity after fracture of the lateral humeral condyle in children. J Pediatr Orthop B 10:142–152PubMed
18.
Zurück zum Zitat Jakob R, Fowles JV, Rang M, Kassab MT (1975) Observations concerning fractures of the lateral humeral condyle in children. J Bone Joint Surg Br 57:430–436CrossRefPubMed Jakob R, Fowles JV, Rang M, Kassab MT (1975) Observations concerning fractures of the lateral humeral condyle in children. J Bone Joint Surg Br 57:430–436CrossRefPubMed
19.
Zurück zum Zitat Thomas DP, Howard AW, Cole WG, Hedden DM (2001) Three weeks of kirschner wire fixation for displaced lateral condylar fractures of the humerus in children. J Pediatr Orthop 21:565–569PubMed Thomas DP, Howard AW, Cole WG, Hedden DM (2001) Three weeks of kirschner wire fixation for displaced lateral condylar fractures of the humerus in children. J Pediatr Orthop 21:565–569PubMed
20.
Zurück zum Zitat Badelon O, Bensahel H, Mazda K, Vie P (1988) Lateral humeral condylar fractures in children: a report of 47 cases. J Pediatr Orthop 8:31–34CrossRefPubMed Badelon O, Bensahel H, Mazda K, Vie P (1988) Lateral humeral condylar fractures in children: a report of 47 cases. J Pediatr Orthop 8:31–34CrossRefPubMed
21.
Zurück zum Zitat Hasler C, von Laer L (2001) Prevention of growth disturbances after fractures of the lateral humeral condyle in children. J Pediatr Orthop B 10:123–130PubMed Hasler C, von Laer L (2001) Prevention of growth disturbances after fractures of the lateral humeral condyle in children. J Pediatr Orthop B 10:123–130PubMed
23.
Zurück zum Zitat Flynn JC (1989) Nonunion of slightly displaced fractures of the lateral humeral condyle in children: an update. J Pediatr Orthop 9:691–696CrossRefPubMed Flynn JC (1989) Nonunion of slightly displaced fractures of the lateral humeral condyle in children: an update. J Pediatr Orthop 9:691–696CrossRefPubMed
25.
Zurück zum Zitat Wang YL, Chang WN, Hsu CJ, Sun SF, Wang JL, Wong CY (2009) The recovery of elbow range of motion after treatment of supracondylar and lateral condylar fractures of the distal humerus in children. J Orthop Trauma 23:120–125. doi:10.1097/BOT.0b013e318193c2f3 CrossRefPubMed Wang YL, Chang WN, Hsu CJ, Sun SF, Wang JL, Wong CY (2009) The recovery of elbow range of motion after treatment of supracondylar and lateral condylar fractures of the distal humerus in children. J Orthop Trauma 23:120–125. doi:10.​1097/​BOT.​0b013e318193c2f3​ CrossRefPubMed
26.
Zurück zum Zitat Sinikumpu JJ (2015) Too many unanswered questions in children’s forearm shaft fractures: high-standard epidemiological and clinical research in pediatric trauma is warranted. Scand J Surg 104:137–138. doi:10.1177/1457496915594285 CrossRefPubMed Sinikumpu JJ (2015) Too many unanswered questions in children’s forearm shaft fractures: high-standard epidemiological and clinical research in pediatric trauma is warranted. Scand J Surg 104:137–138. doi:10.​1177/​1457496915594285​ CrossRefPubMed
27.
Zurück zum Zitat Leonidou A, Chettiar K, Graham S, Akhbari P, Antonis K, Tsiridis E, Leonidou O (2014) Open reduction internal fixation of lateral humeral condyle fractures in children. A series of 105 fractures from a single institution. Strateg Trauma Limb Reconstr 9:73–78CrossRef Leonidou A, Chettiar K, Graham S, Akhbari P, Antonis K, Tsiridis E, Leonidou O (2014) Open reduction internal fixation of lateral humeral condyle fractures in children. A series of 105 fractures from a single institution. Strateg Trauma Limb Reconstr 9:73–78CrossRef
28.
Zurück zum Zitat Pennington R, Corner J, Brownlow H (2009) Milch’s classification of paediatric lateral condylar mass fractures: analysis of inter-and intraobserver reliability and comparison with operative findings. Injury 40:249–252CrossRefPubMed Pennington R, Corner J, Brownlow H (2009) Milch’s classification of paediatric lateral condylar mass fractures: analysis of inter-and intraobserver reliability and comparison with operative findings. Injury 40:249–252CrossRefPubMed
29.
Zurück zum Zitat Flynn JC, Matthews JG, Benoit RL (1974) Blind pinning of displaced supracondylar fractures of the humerus in children. sixteen years’ experience with long-term follow-up. J Bone Joint Surg Am 56:263–272CrossRefPubMed Flynn JC, Matthews JG, Benoit RL (1974) Blind pinning of displaced supracondylar fractures of the humerus in children. sixteen years’ experience with long-term follow-up. J Bone Joint Surg Am 56:263–272CrossRefPubMed
30.
Zurück zum Zitat Beals RK (1976) The normal carrying angle of the elbow. A radiographic study of 422 patients. Clin Orthop Relat Res 119:194–196 Beals RK (1976) The normal carrying angle of the elbow. A radiographic study of 422 patients. Clin Orthop Relat Res 119:194–196
31.
Zurück zum Zitat Sinikumpu J, Victorzon S, Pokka T, Lindholm E, Peljo T, Serlo W (2016) The long-term outcome of childhood supracondylar humeral fractures. Bone Joint J 98:1410–1417CrossRefPubMed Sinikumpu J, Victorzon S, Pokka T, Lindholm E, Peljo T, Serlo W (2016) The long-term outcome of childhood supracondylar humeral fractures. Bone Joint J 98:1410–1417CrossRefPubMed
32.
Zurück zum Zitat Crosby CA, Wehbé MA (1994) Hand strength: normative values. J Hand Surg 19:665–670CrossRef Crosby CA, Wehbé MA (1994) Hand strength: normative values. J Hand Surg 19:665–670CrossRef
33.
Zurück zum Zitat Cusick MC, Bonnaig NS, Azar FM, Mauck BM, Smith RA, Throckmorton TW (2014) Accuracy and reliability of the mayo elbow performance score. J Hand Surg 39:1146–1150CrossRef Cusick MC, Bonnaig NS, Azar FM, Mauck BM, Smith RA, Throckmorton TW (2014) Accuracy and reliability of the mayo elbow performance score. J Hand Surg 39:1146–1150CrossRef
34.
Zurück zum Zitat de Boer YA, Hazes JM, Winia PC, Brand R, Rozing PM (2001) Comparative responsiveness of four elbow scoring instruments in patients with rheumatoid arthritis. J Rheumatol 28:2616–2623PubMed de Boer YA, Hazes JM, Winia PC, Brand R, Rozing PM (2001) Comparative responsiveness of four elbow scoring instruments in patients with rheumatoid arthritis. J Rheumatol 28:2616–2623PubMed
35.
Zurück zum Zitat Duruöz MT (2014) Hand function: a practical guide to assessment. Springer, Berlin Duruöz MT (2014) Hand function: a practical guide to assessment. Springer, Berlin
36.
Zurück zum Zitat Lehtinen JT, Kaarela K, Belt EA, Kauppi MJ, Skytta E, Kuusela PP, Kautiainen HJ, Lehto MU (2001) Radiographic joint space in rheumatoid elbow joints. A 15-year prospective follow-up study in 74 patients. Rheumatology (Oxford) 40:1141–1145CrossRef Lehtinen JT, Kaarela K, Belt EA, Kauppi MJ, Skytta E, Kuusela PP, Kautiainen HJ, Lehto MU (2001) Radiographic joint space in rheumatoid elbow joints. A 15-year prospective follow-up study in 74 patients. Rheumatology (Oxford) 40:1141–1145CrossRef
37.
Zurück zum Zitat Van Vugt A, Severijnen R, Festen C (1988) Fractures of the lateral humeral condyle in children: late results. Arch Orthop Trauma Surg 107:206–209CrossRefPubMed Van Vugt A, Severijnen R, Festen C (1988) Fractures of the lateral humeral condyle in children: late results. Arch Orthop Trauma Surg 107:206–209CrossRefPubMed
38.
Zurück zum Zitat Ippolito E, Tudisco C, Farsetti P, Caterini R (1996) Fracture of the humeral condyles in children: 49 cases evaluated after 18–45 years. Acta Orthop Scand 67:173–178CrossRefPubMed Ippolito E, Tudisco C, Farsetti P, Caterini R (1996) Fracture of the humeral condyles in children: 49 cases evaluated after 18–45 years. Acta Orthop Scand 67:173–178CrossRefPubMed
40.
Zurück zum Zitat France J, Strong M (1992) Deformity and function in supracondylar fractures of the humerus in children variously treated by closed reduction and splinting, traction, and percutaneous pinning. J Pediatr Orthop 12:494–498CrossRefPubMed France J, Strong M (1992) Deformity and function in supracondylar fractures of the humerus in children variously treated by closed reduction and splinting, traction, and percutaneous pinning. J Pediatr Orthop 12:494–498CrossRefPubMed
41.
Zurück zum Zitat Salgueiro L, Roocroft JH, Bastrom TP, Edmonds EW, Pennock AT, Upasani VV, Yaszay B (2015) Rate and risk factors for delayed healing following surgical treatment of lateral condyle humerus fractures in children. J Pediatr Orthop. doi:10.1097/BPO.0000000000000578 Salgueiro L, Roocroft JH, Bastrom TP, Edmonds EW, Pennock AT, Upasani VV, Yaszay B (2015) Rate and risk factors for delayed healing following surgical treatment of lateral condyle humerus fractures in children. J Pediatr Orthop. doi:10.​1097/​BPO.​0000000000000578​
43.
Zurück zum Zitat Morris S, McKenna J, Cassidy N, Stephens M (2000) A new technique for treatment of a non-union of a lateral humeral condyle. Injury 31:557–559CrossRefPubMed Morris S, McKenna J, Cassidy N, Stephens M (2000) A new technique for treatment of a non-union of a lateral humeral condyle. Injury 31:557–559CrossRefPubMed
44.
Zurück zum Zitat Schneeberger AG, Kösters MC, Steens W (2014) Comparison of the subjective elbow value and the mayo elbow performance score. J Shoulder Elbow Surg 23:308–312CrossRefPubMed Schneeberger AG, Kösters MC, Steens W (2014) Comparison of the subjective elbow value and the mayo elbow performance score. J Shoulder Elbow Surg 23:308–312CrossRefPubMed
Metadaten
Titel
Paediatric lateral humeral condylar fracture outcomes at twelve years follow-up as compared with age and sex matched paired controls
verfasst von
Juha-Jaakko Sinikumpu
Tytti Pokka
Sarita Victorzon
Eija-Leena Lindholm
Willy Serlo
Publikationsdatum
08.04.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
International Orthopaedics / Ausgabe 7/2017
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-017-3451-0

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