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Comparison between Fixation with Smooth Kirschner Wire and Cannulated Screws in Displaced Fractures of the Lateral Humeral Condyle in Children

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Objective  To compare the use of cannulated screws and smooth Kirschner wires in terms of reducing the presence of exuberant callus and complications in pediatric displaced fractures of the lateral… Click to show full abstract

Objective  To compare the use of cannulated screws and smooth Kirschner wires in terms of reducing the presence of exuberant callus and complications in pediatric displaced fractures of the lateral humeral condyle. Methods  An analytical cross-sectional study of consecutive cases was conducted from May to October 2021 with 30 children with displaced external humeral condyle fractures. The functional results regarding pain and range of motion were stratified using the Dhillon grading system. Results  A total of 19 patients underwent Kirschner wire fixation, and 11 underwent cannulated screw fixation. Closed fixation was performed in 14 cases (47%), and open fixation, in 16 (53%). Of the cases included, there was no loss to follow-up. Te sample was composed of 21 (70%) male patients, and the age ranged from 5 to 15 years, with a mean of 6.96 years. The most frequent cause of fracture was fall from height (50%), which was related to greater displacement on baseline radiographs. Complications that were not related to the reduction approach or the implant used were observed in 12 (40%) cases. Conclusion  The present study shows no benefits in relation to the use of smooth pins or cannulated screws to reduce the presence of exuberant callus in the consolidation of the fracture. We see that the complications that arise are related to the severity of the injury, and benefits cannot be identified in the choice of one implant over another. We could see that the Weiss classification helps to define the behavior in favor of open or closed reduction without interfering in kindness of the smooth pin or the cannulated screw for fracture fixation.

Keywords: cannulated screws; smooth kirschner; fixation; humeral condyle

Journal Title: Revista Brasileira de Ortopedia
Year Published: 2022

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