Open reduction and internal fixation of medial epicondylar fractures in children with K-wires

摘要

[Purpose] Medial epicondylar fractures of the humerus in children sometimes need open reduction and internal fixation. In these cases, a screw is usually chosen to obtain a good compression as well as to allow the early active motion to avoid limited range of motion of the elbow after operation. We want to use only K-wires as a simple option in fixation of these fractures. [Study design] K-wires were used for fixation in two cases of incarcerated medial epicondylar fractures. The K-wires were bent, cut and pushed deeply into the deep soft tissue, adjacent to the bone. The stability of the fracture and the range of elbow motion were checked before closing the wound. The patients started the active elbow motion early at the fifth day after operation. The outcomes were assessed with the Mayo Elbow Performance Index. [Results] The range of elbow flexion and extension was found comparable to the normal contralateral elbow. The outcomes of these two cases were excellent with the Mayo Elbow Performance Index. [Conclusions] Open reduction and internal fixation with K-wires is a simple but reliable technique in the treatment of medial epicondylar fractures. It can restore a good range of motion which is comparable to the normal elbow. This technique can be considered as an option besides the screw fixation. [Clinical relevance] Simple fixation with K-wires can be used as an alternate to the screw fixation with comparable results regarding the range of motion restoration and bony fusion.