Zhongguo gu shang = China journal of orthopaedics and traumatology · 2026
[Clinical efficacy of ultrasound-guided closed reduction and percutaneous pin fixation for Jakob type Ⅲ lateral condylar fractures of the humerus in children].
Аннотация на английскомСтатьяНазвание и аннотация: Перевод в очереди
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Zhang Chuanwei, Wang Lei, Chen Dengshan, Yang Bo, Ding Xingpo
Аннотация
OBJECTIVE: To investigate the safety and effectiveness of ultrasonic guided Kirschner wire prying reduction and pin fixation in the treatment of Jacob Ⅲ type external condylar fracture of the humerus in children.
METHODS: A retrospective analysis was conducted on the clinical data of 18 pediatric patients with Jakob Type Ⅲ lateral condyle fractures of the humerus, treated between March 2020 and March 2021. All patients underwent ultrasound-assisted closed reduction and percutaneous Kirschner wire fixation using a levering technique within 36 to 48 hours post-injury. The cohort included 13 males and 5 females, with 7 patients on the left side and 11 patients on the right;ages ranged from 2 years and 4 months to 7 years and 5 months. Intraoperatively, prior to reduction, color Doppler ultrasound was used to assess fracture displacement across three elbow views (anterolateral, anterior midline, and lateral). Following ultrasound-guided reduction with K-wire levering, the reduction quality was evaluated using four standard views (anterolateral, anterior midline, lateral, and posterolateral). After pin fixation, the reduction was further assessed using both ultrasound and arthrography. Postoperatively, outpatient follow-ups were conducted at 6 weeks, and at 3, 6, 12, and 24 months. Elbow range of motion (ROM) was recorded and evaluated with X-rays at each visit. The final therapeutic efficacy was assessed using Mayo elbow performance score.
RESULTS: All patients were followed up for 8 to 24 months, and all achieved the standard for fracture healing. Closed reduction was successfully achieved in 15 cases, while 3 required open reduction. Bony union was achieved in all cases at 6 weeks post-reduction. At the final follow-up, the Mayo elbow performance scores ranged from 80 to 100, with 14 cases rated as excellent and 4 as good. Bone spurs (osteophytes) developed on the lateral side of the elbow in 4 cases, and 1 case presented with pin tract irritation. No severe complications, such as nonunion, malunion, delayed union, or avascular necrosis, were observed.
CONCLUSION: For Jakob type Ⅲ lateral condylar fractures of the humerus in children, ultrasound-guided closed reduction combined with K-wire levering and percutaneous fixation is a safe and effective treatment strategy.
METHODS: A retrospective analysis was conducted on the clinical data of 18 pediatric patients with Jakob Type Ⅲ lateral condyle fractures of the humerus, treated between March 2020 and March 2021. All patients underwent ultrasound-assisted closed reduction and percutaneous Kirschner wire fixation using a levering technique within 36 to 48 hours post-injury. The cohort included 13 males and 5 females, with 7 patients on the left side and 11 patients on the right;ages ranged from 2 years and 4 months to 7 years and 5 months. Intraoperatively, prior to reduction, color Doppler ultrasound was used to assess fracture displacement across three elbow views (anterolateral, anterior midline, and lateral). Following ultrasound-guided reduction with K-wire levering, the reduction quality was evaluated using four standard views (anterolateral, anterior midline, lateral, and posterolateral). After pin fixation, the reduction was further assessed using both ultrasound and arthrography. Postoperatively, outpatient follow-ups were conducted at 6 weeks, and at 3, 6, 12, and 24 months. Elbow range of motion (ROM) was recorded and evaluated with X-rays at each visit. The final therapeutic efficacy was assessed using Mayo elbow performance score.
RESULTS: All patients were followed up for 8 to 24 months, and all achieved the standard for fracture healing. Closed reduction was successfully achieved in 15 cases, while 3 required open reduction. Bony union was achieved in all cases at 6 weeks post-reduction. At the final follow-up, the Mayo elbow performance scores ranged from 80 to 100, with 14 cases rated as excellent and 4 as good. Bone spurs (osteophytes) developed on the lateral side of the elbow in 4 cases, and 1 case presented with pin tract irritation. No severe complications, such as nonunion, malunion, delayed union, or avascular necrosis, were observed.
CONCLUSION: For Jakob type Ⅲ lateral condylar fractures of the humerus in children, ultrasound-guided closed reduction combined with K-wire levering and percutaneous fixation is a safe and effective treatment strategy.