Shaft-Condylar Angle for surgical correction in neglected and displaced lateral humeral condyle fracture in children


Published online: Sep 27 2015

Pornchai MULPRUEK, Chanika ANGSANUNTSUKH, Patarawan WORATANARAT, Paphon SA-NGASOONGSONG, Tulyapruek TAWONSAWATRUK, Pongsthorn CHANPLAKORN

From the Department of Orthopedics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

Abstract

Purpose : To assess the outcome after using the Shaft-Condylar angle (SCA) as intraoperative reference for sagittal plane correction in displaced lateral humeral condyle fractures in children presented 3-weeks after injury. Methods : Ten children, with delayed presentation of a displaced lateral humeral condyle fracture and undergoing surgery during 1999-2011, were reviewed. The goal was to obtain a smooth articular surface with an intraoperative SCA of nearly 40° and nearestanatomical carrying angle. They were allocated into two groups according to the postoperative SCA [Good-reduction group (SCA = 30-50°), and Bad-reduction group (SCA < 30°, > 50°)] and the final outcomes were then compared. Results : All fractures united without avascular necrosis. The Good-reduction group (n = 7) showed a significant improvement in final range of motion and functional outcome compared to the Bad-reduction group (n = 3) (p = 0.02). However, there was no significant difference in pain, carrying angle and overall outcome between both groups. Conclusion : SCA is a possible intraoperative reference for sagittal alignment correction in late presented displaced lateral humeral condyle fractures.