Outcomes of Open Reduction and Internal Fixation of Pediatric Lateral Condyle Fractures of Humerus with Delayed Presentation.
- 1Department of Orthopaedic Surgery, Venkateshwara Institute of Medical Sciences, Gajraula, Uttar Pradesh, India.
Abstract
Delayed presentation of lateral condyle fractures of the humerus in children may result in pain, stiffness, deformity, and functional limitation of the elbow. Surgical fixation is recommended in symptomatic patients; however, outcomes following delayed treatment remain variable. To evaluate the clinical and functional outcomes of open reduction and internal fixation in pediatric patients presenting late (>3 weeks) with fractures of the lateral condyle of the humerus. This retrospective-prospective study included 19 pediatric patients with delayed presentation (>3 weeks) of lateral condyle fractures treated with open reduction and internal fixation using a cannulated screw alone or a screw combined with K-wire fixation. Dome corrective osteotomy was performed in two patients with valgus deformity, and one of them additionally underwent anterior transposition of the ulnar nerve due to symptomatic neuropathy. Radiological union and clinical assessment included pain, elbow range of motion, carrying angle, and complications. Functional outcome was evaluated using the Mayo Elbow Performance Score (MEPS). Statistical analysis included paired t-test, Spearman correlation, and Chi-square test. The mean age was 8.6 ± 2.87 years, and the mean duration from injury to presentation was 13.6 ± 12.57 weeks. The most common presenting complaint was pain with decreased range of motion (63.2%). Mean MEPS improved from 74.6 ± 6.57 preoperatively to 77.5 ± 8.37 postoperatively, which was not statistically significant (P = 0.18). However, elbow range of motion improved significantly, with mean flexion increasing from 116.23° ± 14.6° to 128.63° ± 10.24° and mean extension improving from -10.45° ± 12.8° to 2.7° ± 4.4° (P < 0.001). No significant correlation was found between age and post-operative MEPS (r = 0.23, P = 0.35), and functional outcome showed no association with sex or side of injury (P > 0.05). Complications were minor and manageable. Open reduction and internal fixation without bone grafting for delayed presentation of lateral condyle fractures results in significant improvement in elbow range of motion with satisfactory functional outcomes and acceptable complication rates.
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BibTeX
@article{kumar2026outcomes,
title = {{Outcomes of Open Reduction and Internal Fixation of Pediatric Lateral Condyle Fractures of Humerus with Delayed Presentation.}},
author = {Ashok Kumar and Sandeep Kumar and Dhruv Gupta and Altaf Hussain and Mir Shahid Ul Islam},
journal = {Journal of orthopaedic case reports},
year = {2026},
month = nov,
doi = {10.13107/jocr.2026.v16.i11.8484},
url = {https://europepmc.org/article/MED/42997047},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Outcomes of Open Reduction and Internal Fixation of Pediatric Lateral Condyle Fractures of Humerus with Delayed Presentation.
AU - Ashok Kumar
AU - Sandeep Kumar
AU - Dhruv Gupta
AU - Altaf Hussain
AU - Mir Shahid Ul Islam
PY - 2026
DA - 2026/11/01
JO - Journal of orthopaedic case reports
DO - 10.13107/jocr.2026.v16.i11.8484
UR - https://europepmc.org/article/MED/42997047
AB - Delayed presentation of lateral condyle fractures of the humerus in children may result in pain, stiffness, deformity, and functional limitation of the elbow. Surgical fixation is recommended in symptomatic patients; however, outcomes following delayed treatment remain variable. To evaluate the clinical and functional outcomes of open reduction and internal fixation in pediatric patients presenting late (>3 weeks) with fractures of the lateral condyle of the humerus. This retrospective-prospective study included 19 pediatric patients with delayed presentation (>3 weeks) of lateral condyle fractures treated with open reduction and internal fixation using a cannulated screw alone or a screw combined with K-wire fixation. Dome corrective osteotomy was performed in two patients with valgus deformity, and one of them additionally underwent anterior transposition of the ulnar nerve due to symptomatic neuropathy. Radiological union and clinical assessment included pain, elbow range of motion, carrying angle, and complications. Functional outcome was evaluated using the Mayo Elbow Performance Score (MEPS). Statistical analysis included paired t-test, Spearman correlation, and Chi-square test. The mean age was 8.6 ± 2.87 years, and the mean duration from injury to presentation was 13.6 ± 12.57 weeks. The most common presenting complaint was pain with decreased range of motion (63.2%). Mean MEPS improved from 74.6 ± 6.57 preoperatively to 77.5 ± 8.37 postoperatively, which was not statistically significant (P = 0.18). However, elbow range of motion improved significantly, with mean flexion increasing from 116.23° ± 14.6° to 128.63° ± 10.24° and mean extension improving from -10.45° ± 12.8° to 2.7° ± 4.4° (P < 0.001). No significant correlation was found between age and post-operative MEPS (r = 0.23, P = 0.35), and functional outcome showed no association with sex or side of injury (P > 0.05). Complications were minor and manageable. Open reduction and internal fixation without bone grafting for delayed presentation of lateral condyle fractures results in significant improvement in elbow range of motion with satisfactory functional outcomes and acceptable complication rates.
SN - 2250-0685
SN - 2321-3817
ER -