Comparative study between K-Wires and Cannulated Screws in Fixation of Lateral Condyle Fracture in Children

Abstract

Background: Several methods could be utilized for lateral condyle fractures fixation among children. Among metallic implants used for this fracture fixation, smooth Kirschner wires (K-wires) may be the most commonly used. This research aimed to compare between functional outcome of fixation of displaced lateral condyle fracture in pediatric age group by two different methods, either k wires or cannulated screws.Methods: We carried out this prospective clinical study in Orthopedic Surgery department of Zagazig University Hospitals on 24 children with lateral condyle humeral fractures, who were categorized into two groups: Group 1: included 12 participants who were subjected to open reduction and internal fixation using K- wires, Group 2: included 12 participants who were subjected to open reduction and internal fixation using partially threaded 4 mm cannulated screws. We used Mayo Elbow Performance Score (MEPS) for assessment of functional outcome.Results: In the K-wire group 75% of cases had excellent MEPS and 16.7% of cases had good MEPS. While in cannulated screw group, 83.3% of patients had excellent MEPS and 8.3% had good MEPS, 33.3% of children in K-wire group had lack of 10° of extension and 16.7% had flexion <120°, 8.3% of children in cannulated screw group had flexion <120°, The percentage of motion deficiencies, radiological deformities, complications were significantly higher after K-wire than after cannulated screw (p=0.028, 0.016, and 0.047 respectively). Conclusion: Fixation for displaced lateral condyle fractures using cannulated screw has privilege over k-wire regarding post-operative range of motion, radiological outcomes and complications