Assessment of postoperative range of motion in pediatric patients undergoing surgical reduction and fixation of lateral condyle fractures.

Purpose: The objective of this study was to evaluate the outcomes of various methods of fixation for pediatric lateral condyle fractures. The null hypothesis was that there would be no difference between the three treatment groups and time of return to the full range of motion.

Method: There were three fixation groups-Algemeinshaft fur osteosynthesegragen (AO) cannulated screws (n = 11), buried Steinmann pins (n = 13), and unburied Steinmann pins (n = 36). Variables evaluated were time to return to full range of motion of the elbow, whether therapy was required, average number of follow-up visits, fracture classification (Milch), time to operating room, duration of immobilization, degree of initial fracture displacement, time to radiographic healing, complications, and if manipulation under anesthesia was done, whether this was planned or not.

Results: Average return to full range of motion for Algemeinshaft fur osteosynthesegragen cannulated screw, buried Steinmann pins, and unburied Steinmann pins were 113, 82.7, and 94 days, respectively. A one-way ANOVA revealed a p-value of 0.11711. p-Values were also insignificant for the average number of follow-up visits, time to operating room, and time of immobilization. The p-value for time to radiographic healing was <0.00001, with times for Algemeinshaft fur osteosynthesegragen cannulated screw, buried Steinmann pins, and unburied Steinmann pins being 75, 35, and 34.9 days, respectively. Notably, the Algemeinshaft fur osteosynthesegragen screw group averaged 9 years old, more than twice the Steinmann pin groups' 4 years.

Conclusion: Data from this sample suggest that there is no difference in return to full range of motion when comparing the three fixation methods. There was a difference in time to radiographic healing with Algemeinshaft fur osteosynthesegragen screws taking the longest, potentially due to age differences.