Treatment for fractures of a lateral condyle of the humeus in a child
Date First Published:
July 14, 2005
Last Updated:
July 14, 2005
Report by:
Pranam Patel, medical student (Manchester Royal Infirmary)
Three-Part Question:
in [a child aged 3-12] with [a fractured lateral condyle of the humerus] is [surgical intervention associated with a better oucome than immobilisation]
Clinical Scenario:
an eight year old child presents to the emergency department with signs of a fracture. Radiology shows a fracture of the lateral condyle of the humerus.
Search Strategy:
Medline 1966-June 2005
CINAHL 1982-June 2005
the cocrane library, issue 2, 2005
CINAHL 1982-June 2005
the cocrane library, issue 2, 2005
Outcome:
56 citations of which 1 high quality retrospective clinical trial was found
Relevant Paper(s):
| Study Title | Patient Group | Study type (level of evidence) | Outcomes | Key results | Study Weaknesses |
|---|---|---|---|---|---|
| Lateral condyle fractures in children: a comparison of two approaches to treatment Launay Aug-04 France | 97 children under the age of 12 | retrospective clinical trial | best mode of treatment | surgery leads to better outcome than immobilisation | retrospective in nature, therefore treatment protocols varied according to physican preference at two different institutions. Patients not randomly selected and nor was treatment given. Some patients discontinued follow up. |
| best method of surgery | 3 K-wires associated with better outcome than the use of 2 K-wires | ||||
| mobility after treatment | decreased loss of flexion with surgery. But decreased loss of extension with immobilisation |
Author Commentary:
the treatment of a lateral condle of the humerus fracture is associated with complications and loss of function. surgical management has been shown to lead to less complications after treatment and with decreased loss of flexion after treatment. immobilisation is associated with decreased loss of extension after treatment.
Bottom Line:
surgical management is asasociated with better outcome than immobilsation
References:
- Launay. Lateral condyle fractures in children: a comparison of two approaches to treatment