Comparison of the midterm result between Lag-Screw fixation and K-wires treating displaced medial epicondyle fractures in children

Abstract

Medial epicondyle fractures a prevalent injury, constituting 11% to 20% of all elbow fractures in children and adolescents. Common fixation strategies for displaced medial epicondylar fractures involve the use of K-wires and Lag-Screw fixation. The aim of this retrospective study was to compare 2 methods for treating medial epicondylar fractures in children. In this retrospective study, 26 children with displaced medial epicondyle fractures were included. Patients were divided into 2 groups after reduction: Lag-Screw (LS) group and K-wires group. We compared the operation time, range of motion (ROM), range of rotation (ROR), and Mayo elbow performance score (MEPS). A total of 26 patients were available for a long-term follow-up, with a mean age of 11.6 ± 2.5 years, follow up by 35.7 ± 5.7 months. The average operation time in K-wires group was shorter than the Lag-Screw group. The average ROM, ROR, and MEPS of the 2 groups are excellent in 3 months follow up after operation and maintained excellent results during the final follow-up. Regarding MEPS, ROM, and ROR, there was no significant difference between LS group and KW group. However, the LS group experienced fewer complications than the KW group. Both Lag-Screw and K-wires fixation for medial epicondyle fractures in pediatric patients yield favorable mid-term results when assessed in terms of ROM,ROR, MEPS. K-wires fixation, while having a shorter operation time and saving an additional anesthesia and surgery to remove the implants compare to fixed by Lag-Screw fixation, does come with a higher complication rate.